Circadian blood pressure regulation in hospitalized depressed patients and non-depressed comparison subjects

Neuroendocrine dysregulation and disturbed sleep may interfere with circadian blood pressure regulation. Using a portable device, 24h blood pressure profiles were registered in 69 depressed in-patients and 26 hospitalized, healthy controls. Use of antihypertensive medication was considered to be indicative of hypertension. Blood pressure levels were compared between depressed patients not taking antihypertensive medication and healthy comparison subjects. Patients not receiving antihypertensive medication (n=52) had higher mean 24h systolic blood pressure levels than non-depressed comparison subjects (125.5±14.7 versus 119.6±13.3mmHg, P<0.05). Subgroup analysis revealed this difference to be attributable to patients on hypnotic medication. In depressed patients using antihypertensive agents (n=17), circadian blood pressure levels pointed to a suboptimal control of hypertension. Circadian blood pressure levels had not changed after 5 weeks of antidepressant therapy. Circadian blood pressure monitoring identified a subgroup of depressed patients characterized by higher mean systolic blood pressure levels, the use of hypnotics and a high day/night blood pressure change.

Lederbogen, F. et al. Blood Press Monit 8 (2003) 71–76