TY - JOUR
T1 - Impact of Depression and Demoralization on Blood Pressure Control in African Americans with Hypertension
T2 - Findings from the TRIUMPH Trial
AU - Offidani, Emanuela
AU - Benasi, Giada
AU - Charlson, Mary E.
AU - Ravenell, Joseph E.
AU - Boutin-Foster, Carla
N1 - Publisher Copyright:
© 2017, W. Montague Cobb-NMA Health Institute.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background: African Americans develop hypertension earlier and have worse cardiovascular outcomes than Caucasians. Accumulating evidence suggests that psychological distress may play a role in the observed racial differences in hypertension. Several studies have investigated the relationship between depression and hypertension while little is still known about the role of demoralization. Methods: Using data from the Trial Using Motivational Interviewing, Positive Affect, and Self-affirmation in African Americans with Hypertension (TRIUMPH), logistic regression models were used to estimate differences in blood pressure control at 12 months among participants with demoralization, depression, and both conditions. Results: Our logistic models showed that reported psychosocial symptoms significantly differed in predicting success in blood pressure control at 12 months. Contrast analyses showed that, after adjusting for sociodemographic, clinical, and psychosocial variables, demoralized patients were less likely to achieve blood pressure control than participants without affective conditions (p = 0.020). Similar results emerged for patients with depression (p = 0.042) and both conditions (p = 0.022). Conclusions: Depression can be extremely debilitating and has serious health consequence. Our findings confirm this result and show that, even though depression and demoralization share common features, they are two distinct clinical phenomena with similar negative impact on blood pressure control in African Americans.
AB - Background: African Americans develop hypertension earlier and have worse cardiovascular outcomes than Caucasians. Accumulating evidence suggests that psychological distress may play a role in the observed racial differences in hypertension. Several studies have investigated the relationship between depression and hypertension while little is still known about the role of demoralization. Methods: Using data from the Trial Using Motivational Interviewing, Positive Affect, and Self-affirmation in African Americans with Hypertension (TRIUMPH), logistic regression models were used to estimate differences in blood pressure control at 12 months among participants with demoralization, depression, and both conditions. Results: Our logistic models showed that reported psychosocial symptoms significantly differed in predicting success in blood pressure control at 12 months. Contrast analyses showed that, after adjusting for sociodemographic, clinical, and psychosocial variables, demoralized patients were less likely to achieve blood pressure control than participants without affective conditions (p = 0.020). Similar results emerged for patients with depression (p = 0.042) and both conditions (p = 0.022). Conclusions: Depression can be extremely debilitating and has serious health consequence. Our findings confirm this result and show that, even though depression and demoralization share common features, they are two distinct clinical phenomena with similar negative impact on blood pressure control in African Americans.
UR - http://www.scopus.com/inward/record.url?scp=85038097170&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038097170&partnerID=8YFLogxK
U2 - 10.1007/s40615-017-0439-9
DO - 10.1007/s40615-017-0439-9
M3 - Article
AN - SCOPUS:85038097170
SN - 2197-3792
VL - 5
SP - 913
EP - 918
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 5
ER -