Depression in African-American men may be barrier to high blood pressure control

July 15, 2003

A study from The Johns Hopkins University School of Nursing concludes depression may sabotage efforts to control high blood pressure in urban, African-American men. The researchers found no direct link between depression and high blood pressure, but the depressed men were five times more likely to abuse alcohol, leading to behaviors that counteract efforts to control blood pressure.

The study results, published in the July issue of Annals of Behavioral Medicine, found that more than one-fourth of 190 hypertensive black men from inner-city Baltimore were at high risk for depression. The level of depression correlated significantly with poor adherence to high blood pressure treatment, according to Miyong Kim, Ph.D., R.N., lead author and associate professor at the School of Nursing. She adds that the results demonstrate a need for interventions that address depression as an essential component of care for hypertensive patients.

"People who are depressed are more likely to use alcohol or drugs and less likely to take their medication or follow a low-salt diet. This greatly impacts hypertension and can lead to complications and even death," says Kim. "Better screening for depression among hypertensive patients will lead to better treatment of both conditions as well as an improved quality of life for the patient."

The men in the study were between the ages of 30 and 56 and already enrolled in a Johns Hopkins clinical trial of a blood pressure control program. The study revealed a rate of depression among the men that was three times that of the general population. Low income was found to be the most significant factor predicting depression; more than two-thirds of the participants reported an annual income of less than $10,000.

"Many of the urban black men in this study face a harsh environment and challenges in accessing health care, and it's important to acknowledge that substance abuse may be a way of self-medicating for the depression," says Kim. "The results of our study warrant further investigation in order to construct effective means of caring for this group, but clearly the first step in treating hypertension is to uncover any underlying depression early on."
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The study was supported by grants from the National Institutes of Health National Institute of Nursing Research, the NIH-NCRR, OPD-GCRC, and Merck & Co. Other authors include Hae-Ra Han, Ph.D., R.N., Martha N. Hill, Ph.D., R.N., Linda Rose, Ph.D., R.N., and Mary Roary, M.H.S., all from The Johns Hopkins University School of Nursing.

Johns Hopkins Medical Institutions' news releases are available on an EMBARGOED basis on EurekAlert at http://www.eurekalert.org and from the Office of Communications and Public Affairs' direct e-mail news release service. To enroll, call 410-955-4288 or send e-mail to bsimpkins@jhmi.edu.

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