[The relationship between ambulatory blood pressure variation and symptoms of depression and sleep disturbance in community-dwelling elderly persons with independent activities of daily living]

Abstract

Objective: To clarify the relationship between ambulatory blood pressure variation and symptoms of depression and sleep disturbance in community-dwelling elderly persons with independent activities of daily living.

Methods: The subjects were 41 volunteers in a health education class for the elderly in a rural community. We carried out: (1) an interview about symptoms of depression using the Geriatric Depression Scale (GDS), competence of daily living, subjective daily sleep complaints and past history of disease,; (2) ambulatory blood pressure measurements over 24 hours with a portable device,; (3) sleep-awake judgment by wrist actigrams,; and (4) instructions for self-records of his/her life activities.

Results: (1) The average value for 24 hour-mean diastolic blood pressure was significantly higher in subjects undergoing hypertension treatment. (2) No significant relationship was observed between subjective sleep disturbance and ambulatory blood pressure variation. (3) No significant relationship was observed between objective sleep disturbance assessed by wrist-actigraphy and ambulatory blood pressure variation. (4) Severe depression was related to a lower degree of night decrease in both systolic and diastolic blood pressure in subjects undergoing hypertension treatment, while it was associated with higher average values for 24 hour- and awaking-mean systolic and diastolic blood pressure in subjects not receiving such treatment.

Conclusions: In community-dwelling elderly persons with independent activities of daily living, severer depression was associated with the higher mean blood pressure in subjects not taking medicine for hypertension and with a low degree of night decrease in diastolic blood pressure in those receiving hypertension treatment, while no significant relationship was observed between sleep disturbance and ambulatory blood pressure variation.