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Research ArticleOriginal Research

Antidepressants and Incident Hypertension in Primary Care Patients

Matthew Breeden, Jay Brieler, Joanne Salas and Jeffrey F. Scherrer
The Journal of the American Board of Family Medicine January 2018, 31 (1) 22-28; DOI: https://doi.org/10.3122/jabfm.2018.01.170234
Matthew Breeden
From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
MD
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Jay Brieler
From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
MD
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Joanne Salas
From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
MPH
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Jeffrey F. Scherrer
From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
PhD
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Article Figures & Data

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    Table 1.

    Distribution of Sociodemographics, Covariates, and 5-Year (2010–2015) Cumulative Incidence of Hypertension Among Adult Primary Care Patients, Overall and by ADM Exposure (n = 6244)

    VariableTotal (n = 6244)No ADM (n = 4182)ADM-BP− (n = 1008)ADM-BP+ (n = 1054)P Value
    Hypertension, cumulative incidence774 (12.4)507 (12.1)125 (12.4)142 (13.5).494
    Age (years), mean (SD)46.4 (15.6)46.0 (16.0)47.2 (15.7)47.2 (13.8).012
    White race4297 (68.8)2713 (64.9)772 (76.6)812 (77.0)<.0001
    Female sex3949 (63.2)2449 (58.6)706 (70.0)794 (75.3)<.0001
    Married2968 (47.5)2058 (49.2)426 (42.3)484 (45.9)<.001
    High neighborhood SES3649 (58.4)2378 (56.9)618 (61.3)653 (62.0).001
    High clinic utilization1380 (22.1)628 (15.0)297 (29.5)455 (43.2)<.0001
    Current smoker1164 (18.6)620 (14.8)214 (21.2)330 (31.3)<.0001
    Substance use disorder190 (3.0)65 (1.6)51 (5.1)74 (7.0)<.0001
    Depression771 (12.4)24 (0.6)337 (33.4)410 (38.9)<.0001
    Any anxiety disorder665 (10.7)92 (2.2)289 (28.7)284 (26.9)<.0001
    Obese2365 (37.9)1480 (35.4)413 (41.0)472 (44.8)<.0001
    Hyperlipidemia1429 (22.9)898 (21.5)261 (25.9)270 (25.6).001
    Type 2 diabetes391 (6.3)228 (5.4)79 (7.8)84 (8.0).001
    Vascular disease605 (9.7)356 (8.5)110 (10.9)139 (13.2)<.0001
    • Data are n (%) unless otherwise indicated.

    • ADM, antidepressant medication; BP−, no effect on blood pressure; BP+, increases blood pressure; SD, standard deviation; SES, socioeconomic status.

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    Table 2.

    Survival Models, Hazard Ratios, and 95% Confidence Intervals of the Relationship of Antidepressant Medication Treatment Group and Time to Incident Hypertension among Adult Primary Care Patients (n = 6244), 2010–2015*

    Crude HR (95% CI)Overall adjusted HR (95% CI)
    ADM
        None1.001.00
        BP−1.10 (0.90–1.34)1.08 (0.87–1.33)
        BP+1.30 (1.08–1.57)1.20 (0.97–1.49)
    Age1.04 (1.03–1.05)
    White race0.60 (0.52–0.71)
    Female sex0.93 (0.80–1.08)
    Married1.08 (0.93–1.26)
    High neighborhood SES0.93 (0.79–1.09)
    High clinic utilization1.37 (1.17–1.61)
    Current smoker1.43 (1.21–1.70)
    Substance use disorder1.19 (0.80–1.76)
    Depression0.88 (0.68–1.13)
    Any anxiety disorder0.90 (0.68–1.18)
    Obese1.78 (1.54–2.07)
    Hyperlipidemia1.07 (0.91–1.26)
    Type 2 diabetes1.62 (1.31–1.99)
    Vascular disease0.99 (0.81–1.22)
    • ADM, antidepressant medication; BP−, no effect on blood pressure; BP+, increases blood pressure; CI, confidence interval; HR, hazard ratio; SES, socioeconomic status.

    • ↵* ADM treatment and comorbidities were treated as time-dependent variables.

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The Journal of the American Board of Family     Medicine: 31 (1)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 1
January-February 2018
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Antidepressants and Incident Hypertension in Primary Care Patients
Matthew Breeden, Jay Brieler, Joanne Salas, Jeffrey F. Scherrer
The Journal of the American Board of Family Medicine Jan 2018, 31 (1) 22-28; DOI: 10.3122/jabfm.2018.01.170234

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Antidepressants and Incident Hypertension in Primary Care Patients
Matthew Breeden, Jay Brieler, Joanne Salas, Jeffrey F. Scherrer
The Journal of the American Board of Family Medicine Jan 2018, 31 (1) 22-28; DOI: 10.3122/jabfm.2018.01.170234
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Keywords

  • Antidepressive Agents
  • Blood Pressure
  • Hypertension
  • International Classification of Diseases
  • Primary Health Care
  • Proportional Hazards Models
  • Retrospective Studies

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