Open Access Highly Accessed Research article

Blood pressure values and depression in hypertensive individuals at high cardiovascular risk

Cilia Mejia-Lancheros1, Ramón Estruch234, Miguel Angel Martínez-González35, Jordi Salas-Salvadó236, Dolores Corella237, Enrique Gómez-Gracia38, Miquel Fiol29, José Manuel Santos102, Montse Fitó112, Fernando Arós123, Lluis Serra-Majem133, Xavier Pintó143, Josep Basora1523, José Vicente Sorlí16237, Miguel-Angel Muñoz117* and the PREDIMED Study Investigators

Author Affiliations

1 Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

2 Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición(CIBERobn), Instituto de Salud Carlos III, Madrid, Spain

3 The PREDIMED Study (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain

4 The Department of Internal Medicine of Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain

5 Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain

6 Human Nutrition Department, Hospital Universitari Sant Joan, Institut d’Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain

7 The Department of Preventive Medicine, University of Valencia, Valencia, Spain

8 The Department of Preventive Medicine, University of Malaga, Malaga, Spain

9 Institute of Health Sciences (IUNICS), University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain

10 The Department of Family Medicine, Primary Care Division of Seville, San Pablo Health Center, Seville, Spain

11 Cardiovascular Risk and Nutrition Research Group of Institut Mar d’Investigacions Mèdiques (IMIM)–Research Institute Hospital del Mar, Barcelona, Spain

12 The Department of Cardiology, University Hospital of Alava, Vitoria, Spain

13 The Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain

14 Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

15 Primary Care Division, Catalan Institute of Health, Institut d’Investigació en Atenció Primària Jordi Gol, Tarragona-Reus, Spain

16 Primary Care Division, Valencia Institute of Health, Valencia, Spain

17 Catalan Institute of Health, Institut d’Investigació en Atenció Primària Jordi Gol, Sardenya 375,Entlo, 08025 Barcelona, Spain

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BMC Cardiovascular Disorders 2014, 14:109  doi:10.1186/1471-2261-14-109

Published: 26 August 2014



Hypertension and depression are both important risk factors for cardiovascular diseases. Nevertheless, the association of blood pressure on and depression has not been completely established. This study aims to analyze whether depression may influence the control of blood pressure in hypertensive individuals at high cardiovascular risk.


Cross-sectional study, embedded within the PREDIMED clinical trial, of 5954 hypertensive patients with high cardiovascular risk factor profiles. The relationship between blood pressure control and depression was analyzed. A multivariate analysis (logistic and log-linear regression), adjusting for potential confounders (socio-demographic factors, body mass index, lifestyle, diabetes, dyslipidemia, and antihypertensive treatment), was performed.


Depressive patients, with and without antidepressant treatment, had better blood pressure control (OR: 1.28, CI 95%: 1.06-1.55, and OR: 1.30, CI 95%: 1.03-1.65, respectively) than non-depressive ones. Regarding blood pressure levels, systolic blood pressure values (mmHg) were found to be lower in both treated and untreated depressive patients (Log coefficient Beta: -1.59, 95% CI: -0.50 to -2.69 and Log coefficient Beta: -3.49, 95% CI: -2.10 to -4.87, respectively).


Among hypertensive patients at high cardiovascular risk, the control of blood pressure was better in those diagnosed with depression.

Trial registration

Unique identifier: ISRCTN35739639.

Hypertension; Depression; Blood pressure