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Decreased nocturnal systolic blood pressure fall in older subjects with depression

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Abstract

Depressed subjects have a two-fold increased risk of CV events than non-depressed ones. Altered blood pressure (BP) circadian profile may be one mechanism underlying this association. We studied 135 elderly subjects (mean age 78±6 yrs, range 69–93; 30 M, 87 F). On the basis of the 15-items Geriatric Depression Scale (GDS), score>5 identified subjects with depressive symptoms. Based upon 24-h Ambulatory BP Monitoring (Spacelabs 90207®), the following BP circadian profile measures were examined: SD of 24-h, day, and night SBP, DBP, MBP; 24-h, day, and night SBP and DBP load; night SBP and DBP decline; dipping status for SBP and DBP. Compared with non-depressed subjects (n=61), depressed subjects (n=74) were similar in age and more likely to be women. No significant differences in traditional CV risk factors or in medication use were observed between the two groups. After controlling for age, sex, and traditional CV risk factors, subjects with depressive symptoms presented a significantly lower night-time SBP fall than non-depressed ones (average, −4.4 mmHg for SBP) with a significantly higher occurrence of non-dipper status. The GDS score was an independent significant inverse determinant of 24-h SD of SBP. Depressive symptoms in older subjects are accompanied by lower nocturnal BP fall and are significant independent determinants of SBP variability.

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Authors and Affiliations

  1. UO Geriatria, INRCA/IRCCS, Via Cassia 1167, 00189, Roma, Italy

    Angelo Scuteri MD, PhD, Walter Gianni, Antonio Assisi, Anna Maria Brancati & Anna Modestino

  2. IRCCS Santa Lucia Foundation, Roma, Italy

    Gianfranco Spalletta & Carlo Caltagirone

  3. UO Cardiologia, INRCA IRCCS, Roma, Italy

    Marcello Cangelosi

  4. Cattedra Cardiologia, Ospedale Sant’ Andrea, Universita’ “La Sapienza”, Roma, Italy

    Massimo Volpe

Authors
  1. Angelo Scuteri MD, PhD
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  2. Gianfranco Spalletta
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  3. Marcello Cangelosi
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  4. Walter Gianni
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  5. Antonio Assisi
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  6. Anna Maria Brancati
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  7. Anna Modestino
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  8. Carlo Caltagirone
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  9. Massimo Volpe
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Correspondence to Angelo Scuteri MD, PhD.

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Scuteri, A., Spalletta, G., Cangelosi, M. et al. Decreased nocturnal systolic blood pressure fall in older subjects with depression. Aging Clin Exp Res 21, 292–297 (2009). https://doi.org/10.1007/BF03324918

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  • DOI: https://doi.org/10.1007/BF03324918

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