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Abstract: TH-PO233

Influence of Baseline Depressive Symptoms on the Effect of Blood Pressure (BP) Intervention on Cognitive Outcomes in the SPRINT Trial

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Bissada, George, University of Utah Health, Salt Lake City, Utah, United States
  • Takyi, Augustine, University of Utah Health, Salt Lake City, Utah, United States
  • Hartsell, Sydney Elizabeth, University of Utah Health, Salt Lake City, Utah, United States
  • Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
  • Wei, Guo, University of Utah Health, Salt Lake City, Utah, United States
  • Singh, Ravinder, University of Utah Health, Salt Lake City, Utah, United States
  • Sarwal, Amara, University of Utah Health, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
Background

We examined the hypothesis that baseline depressive symptoms might modify the effects of BP control on cognitive outcomes.

Methods

We used data from SPRINT, an RCT that tested the effects of SBP goal <120 vs <140 mmHg on cardiovascular and cognitive outcomes. Based on Patient Health Questionnaire (PHQ)-9, we defined 3 groups: no (score 0), minimal/mild (score 1-9), moderate/ severe (Scores 10-27) depressive symtpoms. We examined interactions of baseline PHQ9 groups and SBP intervention on adjuducated cognitive outcomes of mild cognitive impairment (MCI) or probable dementia (PD).

Results

Among 8487 SPRINT participants included in the analysis, the three baseline PHQ9 groups were 34.6, 57.9, 7.3 respectively. There were 1243 MCI events and 322 PD events. As shown in Table 1, BP intervention lowered the risk of MCI/PD composite whereas higher baseline PHQ 9 scores were assoicated with higher risk of MCI/PD. Interaction p-values for BP intervention X PHQ 9 groups for MCI/PD, MCI alone and PD alone were 0.94, 0.73 and 0.56, repsectively.

Conclusion

Intensive SBP control resulted in decreased hazard of develpoing MCI/PD and presence of baseline moderate/severe depression was assiocated with significant increase in hazard of developing PD and PD/MCI. Nonetheless, there was no evidence that the effects of BP intervention on cognitive outcomes were modified by baseline depressive symptoms.

OutcomeHazard Ratios (95% Confidence Interval)
SBP InterventionPHQ-0 = 0PHQ-9 1-9PHQ-9 10-27
MCI/PD0.90 (0.81, 1.00)Reference1.08 (0.97, 1.22)1.30(1.02,1.66)
MCI alone0.88(0.78,0.98)Reference1.04(0.92,1.18)1.10(0.84,1.43)
PD0.91(0.72.1.14)Reference1.25(0.97,1.61)1.84(1.07,3.16)

Funding

  • NIDDK Support