{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:53:30Z","timestamp":1788512010714,"version":"build-2803163510"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although there has been accumulating evidence on the elevated risk of depression in hypertensive patients, data regarding depressive disorders in older adults with hypertension and the interplay between factors associated with depression in this population are very limited. Disentangling the mutual influences between factors may help illuminate the pathways involved in the pathogenesis of the comorbidity of depression in hypertension. This study investigated the prevalence of depressive disorders in older Chinese adults with hypertension and examined major correlates of depressive disorders and the interactions between correlates by using classification tree analysis (CTA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 374 older adults with essential hypertension were enrolled from seven urban and six rural primary care centers in Wuhan, China, and interviewed with the Chinese Mini-international Neuropsychiatric Interview 5.0. Family relationship and feelings of loneliness were assessed with standardized questions. A checklist was used to assess the presence of six major medical conditions: diabetes mellitus, heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, chronic gastric ulcer, and arthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 1-month prevalence rate of depressive disorders was 25.7%. The CTA model identified four major correlates of depressive disorders: loneliness was the most salient, followed by arthritis, family relationship, and heart disease. There were statistically significant interactions between loneliness and arthritis, loneliness and family relationship, and arthritis and heart disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Over one out of every four older Chinese adults with hypertension suffer from depressive disorders. Collaborative multidisciplinary management services are needed to reduce the burden of depression in hypertensive older adults, which may include social work outreach services to promote family relationship, mental health services to relive loneliness, and primary care services to manage arthritis and heart disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.1035203","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T05:19:50Z","timestamp":1664947190000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Depressive disorders in older Chinese adults with essential hypertension: A classification tree analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Juan","family":"Ruan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Min","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bao-Liang","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037975","article-title":"Epidemiology of depressive disorders in people living with hypertension in Africa: a systematic review and meta-analysis.","volume":"10","author":"Endomba","year":"2020","journal-title":"BMJ Open."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001317","article-title":"Prevalence of depression in patients with hypertension: a systematic review and meta-analysis.","volume":"94","author":"Li","year":"2015","journal-title":"Medicine (Baltimore)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1097\/HJH.0b013e32835080b7","article-title":"Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies.","volume":"30","author":"Meng","year":"2012","journal-title":"J Hypertens."},{"key":"B4","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1590\/s1807-59322005000300010","article-title":"Hypertension and depression.","volume":"60","author":"Scalco","year":"2005","journal-title":"Clinics (Sao Paulo)."},{"key":"B5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.13723\/j.yxysh.2016.01.023","article-title":"Study on prevalence and correlates of depressive symptoms among patients with essential hypertension from 4 tertiary general hospitals in Guangzhou City and Ningbo City.","volume":"29","author":"Zong","year":"2016","journal-title":"Med Soc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.3936\/j.issn.1002-0152.2015.04.001","article-title":"Current prevalence and correlates of depressive disorder among outpatients with essential hypertension from cardiovascular divisions of tertiary general hospitals.","volume":"28","author":"Zhang","year":"2015","journal-title":"Chin J Nerv Ment Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1093\/eurheartj\/eht462","article-title":"Depression and cardiovascular disease: a clinical review.","volume":"35","author":"Hare","year":"2014","journal-title":"Eur Heart J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1111\/j.1751-7176.2010.00302.x","article-title":"Hypertension and depression: coexisting barriers to medication adherence.","volume":"12","author":"Krousel-Wood","year":"2010","journal-title":"J Clin Hypertens (Greenwich)."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2016.00033","article-title":"Depression and the link with cardiovascular disease.","volume":"7","author":"Dhar","year":"2016","journal-title":"Front Psychiatry."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251326","article-title":"Risk factors and protective factors of depression in older people 65+. 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