Association of Depression with Uncontrolled Hypertension in Primary Care Setting: A Cross-Sectional Study in Less-Developed Northwest China

BACKGROUND: Hypertensive patients commonly experience comorbid depression, which is closely associated with adverse health outcomes. This study aimed to examine the association between depression and uncontrolled hypertension in primary care setting of Northwest China. METHODS: We used a stratified multistage random sampling method to obtain 1856 hypertensives subjects aged ≥18 years among primary care setting in Xinjiang, Northwest China, between April and October 2019. Depression was evaluated by Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. We related depression to uncontrolled hypertension, using multiple logistic regression, adjusting for minimally sufficient adjustment set of variables retrieved from a literature-based directed acyclic graphs (DAGs) and optimal adjustment set of variables derived from the least absolute shrinkage and selection operator (LASSO) regression. RESULTS: A total of 1,653 (89.1%) patients had uncontrolled hypertension. The prevalence of depression was 14.5% and 7.4% among patients with uncontrolled and controlled hypertension. Depression was associated with 1.12-fold increased odds of uncontrolled hypertension [odds ratio (OR) 2.12, 95% confidence interval (CI): 1.23–3.65]. The association remained significant even after adjusting for the minimal sufficient adjustment sets and the optimal adjustment set of variables. CONCLUSION: Depression is significantly associated with uncontrolled hypertension in primary care setting of northwest China. The integrated management of depression and hypertension in the setting might be warranted.