Low-income middle-aged African-American women with hypertension are likely to suffer from depression

February 11, 2021

Low-income middle-aged African-American women with high blood pressure very commonly suffer from depression and should be better screened for this serious mental health condition, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

The researchers found that in a sample of over 300 low-income, African-American women, aged 40-75, with uncontrolled hypertension, nearly 60 percent screened positively for a diagnosis of depression based on a standard clinical questionnaire about depressive symptoms.

The results appeared February 10 in JAMA Psychiatry.

"Our findings suggest that low-income, middle-aged African-American women with hypertension really should be screened for depression symptoms," says study senior author Darrell Gaskin, PhD, William C. and Nancy F. Richardson Professor in Health Policy and director of the Johns Hopkins Center for Health Disparities Solutions in the Bloomberg School's Department of Health Policy and Management.

Recent research suggests that hypertension and depression often occur concurrently. Gaskin and colleagues note that the connection has not been well studied in African Americans, but should be, given they have relatively high rates of hypertension. Moreover, women in general have much higher rates of depression compared to men and depression is often under diagnosed and untreated.

The sample of women in the study were participants in an ongoing clinical trial of the Prime Time Sister Circles intervention--a health education-, lifestyle-change- and support-group-based intervention in Washington, DC, aimed at helping African American women better managed their blood pressure, weight, other chronic conditions and stress levels. The women were in the 40- to 75-age range, and had hypertension (?140 mmHg systolic or ?90 mmHg diastolic) that had been diagnosed at a federally qualified health center. At the outset of the study, the women filled out a standard questionnaire called the CES-D-10 which asks about depression symptoms in the past week. The analysis from the Bloomberg School team covered the 316 women age 40 to 75 who completed the questionnaires.

The researchers found that 180 of the 316, or about 57 percent, scored 10 or greater on the CES-10-D questionnaire--generally considered evidence of significant depressive symptoms. The women in this group were significantly more likely to have a high school education or less, and to be smokers. More than 34 percent of these women reported that at least once in the previous six months they had stayed in bed for more than half the day owing to depression, compared to only 9 percent of the women with CES-D-10 scores below 10.

The nearly 60 percent prevalence of apparent depression among these hypertensive, low-income middle-aged African American women suggests that these women should be routinely screened for, and, if need be, treated for depression, Gaskin and colleagues emphasize.

They note, however, that 85 percent of the women with depression-level CES-D-10 scores reported receiving some treatment for depression within the prior six months--implying that much of the depression among these low-income middle-aged, hypertensive African-American women is already treated, albeit inadequately.

The Prime Time Sister Circles intervention encourages African American women to prioritize and better manage their health. The clinical trial of that intervention, which is focused mainly on its ability to reduce hypertension but secondarily on its impact on depression, is still ongoing.

"We are hopeful that those women who are in that trial will do better not just in regard to depression but also with regard to other underlying factors that may contribute to high blood pressure," Gaskin says.
"Evaluating Depressive Symptoms Among Low Socioeconomic-Status African American Women Aged 40 to 75 Years With Uncontrolled Hypertension" was authored by Angel Gabriel, Hossein Zare, Wehmah Jones, Manshu Yang, Chidinma Ibe, Yidan Cao, Michele Balamani, Marilyn Gaston, Gayle Porter, Denise Woods, and Darrell Gaskin.

Funding was provided by the National Institute on Minority Health and Health Disparities (R01MD010462).

Johns Hopkins University Bloomberg School of Public Health

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.