Association of Depressive Symptoms with Diet, Blood Pressure Change, and Hypertension: The HCHS/SOL

Hypertension (HTN) affects roughly one third of the U.S. population. Concurrently, elevated depressive symptoms have skyrocketed in the past three decades. Both conditions are prevalent among Hispanic/Latino adults, yet few studies have examined their association and potential underlying mechanisms in this population. Using data (N= 10,783 adults) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), this study examined (1) the longitudinal association of depressive symptoms at Visit 1 (2008-11) with changes in BP between Visits 1 and 2 (2014-17) and HTN incidence after six years of follow-up; and (2) the potential mediating role of diet quality on the association of elevated depressive symptoms with changes in BP between visits and incidence of HTN. The target population included 52.2% women, had a mean age of 41.1 years (18 – 75 years) at baseline, and were predominantly of Mexican (38.0%), Cuban (20.3%), Puerto Rican (15.6%), and Dominican (9.3%) background. Results from multivariable Poisson regressions revealed that adults with elevated depressive symptoms at Visit1 had a 20% higher incidence of HTN at Visit 2 than those with lower symptoms after adjusting for sex, age, and sociodemographic factors. This association became attenuated and non-significant after adjusting for clinical variables. Elevated depressive symptoms were not associated with changes in systolic or diastolic BP. Structural equation modeling results showed that diet quality did not mediate the association of depressive symptoms with changes in BP or HTN; however, persons with elevated baseline depressive symptoms had poorer diet quality at Visit 1 than those with lower symptoms. These findings underscore the important role of elevated depressive symptoms as a risk factor for HTN among Hispanic/Latino adults.