Low Blood Pressure and Depressive Symptoms among Chinese Older Subjects: A Population-based Study

  • Tze-Pin Ng
    Requests for reprints should be addressed to Tze-Pin Ng, MD, Gerontological Research Programme, National University of Singapore, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074
    Gerontological Research Programme, Faculty of Medicine, National University of Singapore, Singapore

    Department of Psychological Medicine, National University of Singapore, Singapore
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  • Liang Feng
    Gerontological Research Programme, Faculty of Medicine, National University of Singapore, Singapore

    Department of Psychological Medicine, National University of Singapore, Singapore
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  • Mathew Niti
    Health Service Research and Evaluation, Ministry of Health, Singapore
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  • Keng-Bee Yap
    Gerontological Research Programme, Faculty of Medicine, National University of Singapore, Singapore

    Department of Geriatrics Medicine, Alexandra Hospital, Singapore
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      The relationships between blood pressure and depression are unclear. There are inconsistent reports of an association between low blood pressure and depressive symptoms.


      In a population-based sample of 2611 Chinese older adults aged 55 years and above, including participants with treated (n = 1088), untreated (n = 545), or no hypertension (n=978), depressive symptoms were determined by the 15-item Geriatric Depression Scale (≥5), and current systolic blood pressure and diastolic blood pressure measurements were used to classify participants into high, normal, and low blood pressure groups. Estimates of association were adjusted for confounding by use of antihypertensive and depressogenic drugs and other covariables in hierarchical regression analyses.


      Systolic blood pressure and diastolic blood pressure were negatively associated with Geriatric Depression Scale scores, independent of other variables. Low systolic blood pressure (odds ratio [OR] 1.54; 95% confidence interval [CI], 1.07-2.22), low diastolic blood pressure (OR 1.67; 95% CI, 0.98-2.85), and low systolic blood pressure or diastolic blood pressure (or both) (OR 1.55; 95% CI, 1.10-2.19) were independently associated with depressive symptoms. The associations with depressive symptoms were particularly observed for low systolic blood pressure (OR 2.13; 95% CI, 1.13-4.03) among treated hypertensive participants, and low diastolic blood pressure (OR 2.42; 95% CI, 1.26-4.68) among untreated or nonhypertensive participants.


      Low blood pressure was independently associated with depressive symptoms in both older subjects who were treated for hypertension and those who were not.


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