Abstract P044: Associations Between Depression and Hypertension among Women and Men Veterans

Background: Hypertension increases the risk of cardiovascular disease. Literature describing associations between depression and blood pressure is inconsistent, potentially due to differing associations by sex. Veterans have high burdens of both depression and hypertension, respectively, and thus are a critical population in which to understand possible individual differences. Thus, among Veterans, we estimated the association between depression and hypertension and determined if this differs by sex. Methods: We used 2001-2017 nationwide Veterans Health Administration data from Veterans who served in support of conflicts in Afghanistan and Iraq. Major depressive disorder (MDD), mild depression, or no depression (reference group) were defined based on ICD-9/ICD-10-CM codes. Multivariable logistic regression models tested if depression status (independent variable) affected the risk of hypertension (dependent variable; defined as ≥2 blood pressure readings ≥140 systolic or ≥90 diastolic), controlling for sociodemographic factors, smoking, and comorbid mental health conditions. The adjusted model was also stratified by sex. Results: Among 761,627 Veterans (13.0% women; median age [interquartile range]= 29.5 [25.2-39.2] years), 24.1% had MDD, 18.8% mild depression, and 57.1% no depression. MDD was more prevalent for women than men (32.4% vs. 22.8%; p <0.001). Hypertension was more common among Veterans with MDD (48.6%), compared to those with mild depression (40.7%) or no depression (28.0%; p <0.001). In adjusted analyses, those with MDD had a 2.46xgreater risk of hypertension (95% CI, 2.43-2.49) and those with mild depression had 1.76xgreater risk (95% CI, 1.73-1.78) vs. those with no depression. In sex-stratified analyses, adjusted odds ratios were similar for women and men (MDD: 2.43 for women, 2.46 for men; mild depression: 1.74 for women, 1.75 for men). Conclusion: Both major and minor depression are associated with an increased risk of hypertension, with similar risk observed for women and men. Given the high burden of both depression and hypertension in this younger population, the potential long-term health implications of these conditions may warrant targeted intervention to prevent cardiovascular disease.