Low-income Black women with uncontrolled hypertension at increased risk for depression
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More than half of low-income African American women with uncontrolled hypertension had symptoms of depression, according to results of a secondary analysis of a randomized clinical trial published in JAMA Psychiatry.
“Despite being at elevated risk for hypertension and other chronic conditions, low-income African American women are understudied,” Darrell J. Gaskin, PhD, MS, of the department of health policy and management at Johns Hopkins Bloomberg School of Public Health, told Healio Psychiatry. “The study evaluated whether the Prime Time Sister Circles intervention can help these women better manage their overall health, including their blood pressure and depressive symptoms.”
According to Gaskin and colleagues, the Prime Time Sister Circles (PTSC) intervention addresses contextual factors that affect cardiovascular disease outcomes among African American women. It includes primary and secondary strategies such as education (knowledge about hypertension sequalae); behavioral (self-reported adherence); hypertension and cardiovascular disease risk factors (eg, poor nutrition, inactivity and increased stress); psychosocial (ie, stress management and self-efficacy to manage blood pressure); clinical (blood pressure control, waist circumference and BMI); and health care use (hospitalizations and inpatient admissions).
The researchers conducted a cross-sectional analysis of data from the PTSC randomized controlled trial (PTSC-RCT) to evaluate depressive symptom prevalence among 316 low-socioeconomic status African American women aged 40 to 75 years who had uncontrolled hypertensions and received care from a federally qualified health center, as well as to pinpoint risk factors linked to depressive symptoms. Investigators of the PTSC-RCT had used an adapted version of the 10-item Center for Epidemiological Studies Depression Scale Revised (CES-D-10) to measure depressive symptomology. Gaskin and colleagues investigated the factors linked to participants with or without symptoms of depression using logistic regression.
Results showed a score of 10 or greater on the CES-D-10 among 57% of participants. The researchers noted a negative association between depressive symptoms and postsecondary education (adjusted OR = 0.492; 95% CI, 0.249-0.968) and a positive association with the number of chronic conditions (aOR = 1.235; 95% CI, 1.046-1.46) and smoking (aOR = 1.731; 95% CI, 1.039-2.881).
“These depressive symptoms persist despite the women receiving some mental health treatment, suggesting that their treatment was not sufficient to resolve their depressive symptoms,” Gaskin said. “Federally qualified health centers serving low-income African American women with hypertension should consider screening these women for depression and provide effective treatment for those who screen positive.”