UMLS:C0020538 - FACTA Search

Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this paper is to assess the influence of selected psychosocial factors as predictors of stroke incidence in a probability sample of noninstitutionalized elderly. The main psychosocial factor of interest was depression. Marital status, social support, social networks, and religiousness were also assessed as potential antecedent or mediating factors. The data were obtained from a prospective longitudinal study based on 2,812 individuals aged 65 years and over living in New Haven, Connecticut. The incidence of stroke was monitored from the baseline interview in 1982 until December 1988. Depression, measured by the Center for Epidemiologic Studies Depression Scale (CES-D), was measured at baseline as were other predictor variables. Univariate Cox regression analyses revealed that higher CES-D scores were predictive of greater stroke incidence (p < 0.05). More frequent attendance at religious services was associated with lower incidence (p < 0.001). CES-D scores were also correlated with many measures of sociodemographic, health, and physical function factors in our multivariate analysis (p < 0.05). When combined with other significant predictor variables such as age, sex, hypertension, diabetes, physical function, and smoking, neither depression nor religious attendance retained its significance.
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PMID:Depressive symptoms and other psychosocial factors as predictors of stroke in the elderly. 144 54

To evaluate the effects on depressive mood of withdrawal of antihypertensive medication, we conducted a randomized, multi-center study with clinical centers at the Albert Einstein College of Medicine, Bronx, NY, University of Alabama School of Medicine, Birmingham, and the University of Mississippi School of Medicine in Jackson. Patients were formerly active participants in the Hypertension Detection and Follow-Up Program (HDFP) whose blood pressure was controlled with drugs for a period of 5 years. Of 496 patients, 431 had both baseline and "1-year" mood scores. Patients, stratified by obesity, were randomized to one of three groups: continue the HDFP medication; discontinue medication with no dietary intervention, or with sodium restriction and potassium increase; or, for those overweight, to a weight reduction intervention. Depression was assessed using the CES-D scale (Center for Epidemiological Studies--Depressed Mood), administered at baseline and again approximately 1 year after randomization. Of the seven treatment groups, only those who continued their HDFP medication showed significant improvement in mood from baseline. The overweight continue-medication group showed significantly greater improvement compared to the no-drugs, no-diet intervention groups, and to the overweight sodium-restriction group. Patients who had their blood pressure successfully controlled with weight reduction had a significant improvement in mood from 11.0 scale points to 8.0, P = .006. Comparisons between those withdrawn from diuretic alone and those withdrawn from both diuretic plus reserpine were inconclusive. Dietary Intervention Study of Hypertension (DISH) shows no evidence that continued use of chlorthalidone has a negative impact on quality of life, while our results concerning reserpine were inconclusive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of withdrawal of antihypertensive drug on depressive mood. 813 96

In order to determine the prevalence of depressive symptomatology among the elderly in Japan, and examine relevant factor, a comprehensive survey was conducted. Subjects were 695 men and women aged 65 years and over in a rural village of Akita Prefecture. The Japanese version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) was used as the measure of depressive symptomatology. The main results were as follows: 1. The score distribution was skewed to the right, more so than those in preceding studies from the United States. The prevalence of depression according to a CES-D cut-point of 16 or greater was 5.3%. Neither age nor sex differences in prevalence were found. 2. Risk factors for circulatory disease such as blood pressure, ECG findings, chest X-P and blood components were not found to be related to CES-D score. Only the eye-ground change according to the Scheie's S classification was directly and significantly related to depression. 3. Those who had been treated for stroke over a year prior to the survey tended to have higher CES-D scores. Neither history of hypertension nor heart disease was associated with CES-D score. 4. Depression was more common among those who had experienced admission to hospitals over a year prior to the survey or who had suffered from hearing impairment or visual impairment. Low activities of daily living directly and significantly affected CES-D scores.
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PMID:[Depressive states and their correlates in elderly people living in a rural community]. 847 98

Several authors have reported that older African-Americans with multiple medical problems and decreased activities of daily living are at an increased risk of reporting symptoms of depression. African-Americans were more likely to report symptoms of anger, irritability, denial of illness, and to spontaneously report symptoms that did not reflect a change in mood, but rather forbearance of a difficult time or somatic complaints. This paper describes the results of a study to assess the presence of depressive symptoms in older African-American community residents. A new instrument, the Baker Belief Scale, is compared with the Center for Epidemiologic Studies-Depression Scale (CES-D) and the association of medical illnesses, social network, and level of physical function in activities of daily living (ADL). Ninety-six African-American men and women, aged 60 years or older, with equal representation from urban and rural counties in western Tennessee comprised the sample. The sample was stratified, in each of the two counties, into three age categories; 60-69, 70-79, and 80 years and older. A screening battery consisting of the Short Portable Mental Status Questionnaire, the CES-D, the Lubben Social Network Scale, and the Katz ADL were administered to the sample. Current medical illnesses were recorded with demographic data. There was a significant association between the CES-D score and the BBS score for those who screened positive for symptoms of depression. In addition there was a significant relationship between CES-D score and specific medical illnesses, social network, physical function in ADL, and residence (urban vs. rural). Residents who screened positive (N = 19) for depressive symptomatology with CES-D scores of 16 or higher exhibited a higher frequency of hypertension, arteriosclerosis, and circulatory problems than those who tested negative (N = 77). More urban residents (N = 13) than rural residents (N = 6) screened positive for symptoms of depression. Approximately 21% (N = 20) of the 96 respondents had scores of 20 or less on the Lubben Social Network Scale, suggesting a group of "at risk" for social isolation.
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PMID:Screening African-American elderly for the presence of depressive symptoms: a preliminary investigation. 887 76

We examined the prevalence of HIV, general medical, and psychiatric comorbidities by age based on a recent multisite cohort of HIV infected veterans receiving care: the Veterans with HIV/AIDS 3 Site Study (VACS 3). VACS 3 includes 881 adult patients with HIV infection enrolled between June 1999 and July 2000. Providers reported their patients' CDC-defined HIV comorbidities, general medical comorbidities (based on Duke and Charlson comorbidity scales), and psychiatric comorbidity. Mean age of participants was 49 years and 54% were African-American. The most common HIV comorbidities were oral candidiasis (21%), peripheral neuropathy (16%), and herpes zoster (16%). The most common general medical comorbidities included chemical hepatitis (53%), hypertension (24%), and hyperlipidemia (17%). The mean number of HIV and general medical comorbidities experienced by patients were respectively 1.1 and 1.4 (P < .001). Older (> or = 50 years) HIV-infected patients experienced a greater number of general medical comorbidities than those < 50 years (respectively 1.7 versus 1.2, P < .001). There was no significant difference in mean HIV comorbidity number by age. Based on patient report, 46% had significant depressive symptoms (> or = 10 on 10-item CES-D) and 21% reported at-risk drinking (> or = 8 on AUDIT). Providers reported 32% of patients had anxiety, 4% mania, 4% schizophrenia, and 11% cognitive impairment/dementia. General medical and psychiatric comorbidities constituted a higher disease burden for HIV-infected veterans than HIV comorbidities. Whether these comorbidities are due to antiretroviral drug toxicity or are age or lifestyle-associated conditions, the substantial prevalence of these "non-HIV" comorbidities suggest an important role for general medical and psychiatric management of HIV-infected patients.
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PMID:General medical and psychiatric comorbidity among HIV-infected veterans in the post-HAART era. 1175 Feb 6

By promoting atherosclerosis and thrombosis, a blood-clotting diathesis could contribute to excess cardiovascular morbidity and mortality in patients with systemic hypertension and/or obstructive sleep apnoea. Since psychological states affect haemostatic activity, we wondered about the contribution of behavioural factors to a hypercoagulable state in subjects with increased risk of cardiovascular disease. To tease apart the potential additive nature of cardiovascular disease risk, we examined four patient groups - hypertensives and normotensives, with and without sleep apnoea. The procoagulant molecules thrombin-antithrombin III complex, fibrin D-dimer and von Willebrand factor antigen were measured in 88 subjects (mean age 47 years; range 32-64 years) who underwent full polysomnography. Subjects completed the Center for Epidemiological Studies - Depression (CES-D) Scale, the Cook-Medley (CM) Hostility Scale, and the Profile of Mood States (POMS). Sleep apnoea, hypertension status, age, body mass index and psychological variables (CES-D, CM Stress, and POMS Vigour-Activity) together explained 29% of the variance in D-dimer, a marker of fibrin turnover ( r (2)=0.29, P =0.001). CES-D, CM Stress and POMS Vigour-Activity explained 17% of this variance even after controlling for sleep apnoea, hypertension status, age and body mass index (Delta r (2)=0.17, P =0.001). Thrombin-antithrombin III complex and von Willebrand factor were not significantly related to psychological variables, but this may reflect limited statistical power. Thus psychological factors are independently associated with D-dimer and explain as much of its variance as do traditional correlates (hypertension, sleep apnoea, age and body mass index). These results may provide a rationale for linking behavioural aspects with cardiovascular events.
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PMID:Independent contribution of psychological factors to fibrin turnover in subjects with sleep apnoea and/or systemic hypertension. 1224 29

Research on comorbidity across cancer symptoms, including pain, fatigue, and depression, could suggest if crossover effects from symptom-specific interventions are plausible. Secondary analyses were conducted on a survey of 268 cancer patients with recurrent disease from a northeastern U.S. city who were initiating palliative radiation for bone pain. Moderator regression analyses predicted variation in depressive affect that could be attributed to symptom clusters. Patients self-reported difficulty controlling each physical symptom over the past month on a Likert scale and depressive symptoms on a validated depression measure (Center for Epidemiologic Studies-Depression [CES-D]) over the past week on a four-category scale. An index of depressive affect was based on items of negative and positive affect from the CES-D. In predicting depressive affect, synergistic interactions of pain with fever, fatigue, and weight loss suggest separate pathways involving pain. A similar interaction with fever occurs when nausea was tested in place of pain. Further, the interaction between pain and fatigue is similar in form to the interaction between difficulty breathing and fatigue (when sleep is not a problem). Follow-up to the latter interaction reveals: 1) additional moderation by hypertension and palliative radiation to the hip/pelvis; and 2) a similar cluster not involving hypertension when appetite problems and weight loss were tested in place of fatigue. The significance and form of these interactions are remarkably consistent. Similar sickness mechanisms could be generating: 1) pain and nausea during fever; 2) pain and fatigue during weight loss; and 3) pain and breathing difficulty when fatigue is pronounced. Crossover effects from symptom-specific interventions appear promising.
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PMID:The relationship of cancer symptom clusters to depressive affect in the initial phase of palliative radiation. 1573 6

To examine the association between presence of clinically relevant depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score >or= 16) and subsequent cognitive function (Mini-Mental State Examination [MMSE]) over a 7-year period in older Mexican Americans, a prospective cohort study was performed. Five south-western states contributed data to the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Participants included 2812 noninstitutionalized Mexican Americans aged 65 and older followed from 1993-1994 until 2000-2001. Cognitive change was assessed using the MMSE at baseline and at 2, 5, and 7 years of follow-up. Independent variables were sociodemographics, CES-D >or= 16, medical conditions (hypertension, diabetes, coronary artery disease, and stroke), and activities of daily living (ADL) status. A general linear mixed model was used to estimate cognitive change. There was a cross-sectional association between CES-D >or= 16 and lower MMSE score (estimate = -0.48; standard error [SE] = 0.15; P < .01), independent of age, gender, education, marital status, time of interview, ADL limitations, vision impairment, and medical conditions. In the fully adjusted longitudinal model, subjects with clinically relevant depressive symptoms had a greater decline in MMSE score over 7 years than those without clinically relevant depressive symptoms (estimate = -0.17; SE = 0.05; P < .001), adjusting for sociodemographics, ADL and medical conditions. Each point increase in the CES-D score was associated with a decline of 0.010 point in MMSE score per year (SE = 0.002; P < 0.0001), adjusting for relevant confounders. Presence of clinically relevant depressive symptoms was associated with subsequent decline in cognitive function over 7 years in older Mexican Americans, independent of demographic and health factors.
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PMID:Depressive symptoms and cognitive change in older Mexican Americans. 1771 97

Psychosocial stress and depressive symptoms are associated with increased risk of negative perinatal outcomes including preterm delivery and gestational hypertension. Inflammation is a likely mechanism by which distress may promote these outcomes. It is well-established that stress and depressive symptoms are associated with elevated serum inflammatory markers in nonpregnant populations. However, the immune system exhibits significant changes during pregnancy. Thus, the extent to which these findings extend to pregnancy is largely unknown. The current study examined associations among perceived stress, depressive symptoms, and serum inflammatory markers in a sample of 60 pregnant women. Fifty seven percent were African-American, 82% had completed high school or less education, and 63% reported an annual family income below $15,000. Participants completed the Perceived Stress Scale (PSS) and the Center for Epidemiologic Studies Depression Scale (CES-D). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were determined using high sensitivity immunoassays. Regression analyses demonstrated that after controlling for pre-pregnancy Body Mass Index (BMI), higher scores on the CES-D were related to significantly higher levels of IL-6 (beta=.23, p=.05) and marginally higher TNF-alpha (beta=.24, p=.06). Perceived stress was not significantly related to serum levels of IL-6 or TNF-alpha. In sum, these results indicate that depressive symptoms are associated with higher levels of maternal serum inflammatory markers during pregnancy. These data are consistent with the contention that depressive symptoms may contribute to negative perinatal outcomes via inflammatory pathways.
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PMID:Depressive symptoms are associated with elevated serum proinflammatory cytokines among pregnant women. 1925 33

Policing is one of the most dangerous and stressful occupations and such stress can have deleterious effects on health. The purpose of this study was to examine the association between depressive symptoms and metabolic syndrome (MetSyn) in male and female police officers from two study populations, Buffalo, NY and Spokane, WA. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. MetSyn was defined using the 2005 AHA/NHBLI guidelines. Analysis of covariance was used to describe differences in number of MetSyn components across depressive symptom categories. The number of MetSyn components increased significantly across categories of CES-D for Spokane men only (p-trend = 0.003). For each 5-unit increase in CES-D score, odds increased by 47.6% for having hypertriglyceridemia, by 51.8% for having hypertension, and by 56.7% for having glucose intolerance. Exploring this association is important since both are predictors of future chronic health problems and the results could be helpful in developing future gender-specific prevention and intervention efforts among police officers.
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PMID:Association between depressive symptoms and metabolic syndrome in police officers: results from two cross-sectional studies. 2231 28

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