Hypertension and Depression Together Amplify Risk of Cardiovascular Disease and Early Death, Finds Study
Australia: Middle-aged and older adults suffering from both hypertension and depression face significantly elevated risks of developing cardiovascular disease (CVD) and dying prematurely, according to a new population-based cohort study published in the Journal of Human Hypertension. The research, led by Qiang Tu and colleagues from the Faculty of Medicine and Health at the University of Sydney, sheds light on the compounded health risks associated with these two common conditions when they co-occur.
The study drew on data from the China Health and Retirement Longitudinal Study (CHARLS), which tracked 9,178 individuals aged 45 and older over nine years (2011–2020). None of the participants had prior CVD at the time of enrolment. Researchers categorized participants into four groups: those with neither hypertension nor depression, those with only hypertension, those with only depression, and those with both conditions.
The study led to the following findings:
- Participants with both hypertension and depression had more than twice the odds of developing cardiovascular disease (CVD) compared to those with neither condition (adjusted odds ratio [aOR]: 2.2).
- This group also showed a 52% higher risk of all-cause mortality.
- Individuals with only hypertension had a 94% increased risk of developing CVD (aOR: 1.94).
- Those with hypertension alone also faced a 41% higher risk of all-cause mortality (aOR: 1.41).
- Participants with depression alone had a 57% higher risk of developing CVD (aOR: 1.57).
- Individuals with depression alone showed a marginal 2% increase in all-cause mortality risk (aOR: 1.02).
- Greater severity of depressive symptoms was linked to an even higher risk of both CVD and all-cause mortality, regardless of hypertension status.
- More severe depression was associated with poorer health outcomes, even in individuals without hypertension.
The authors emphasized that while the independent risks of hypertension and depression are well-documented, there has been limited investigation into their combined impact. This research fills a crucial gap and suggests that addressing mental health is just as important as managing blood pressure when it comes to preventing heart disease and early death.
“Our results suggest that coexisting hypertension and depression synergistically increase the risks of CVD and all-cause mortality, more than either condition alone,” the authors wrote. They advocate for integrated care approaches, particularly routine screening and treatment for depression in patients with hypertension.
Given the global burden of both hypertension and depression—especially among aging populations—these findings have major public health implications. The researchers call for heightened clinical awareness and the development of holistic management strategies to reduce the dual burden of these conditions.
The authors concluded, "The study reinforces the need for healthcare providers to go beyond treating physical symptoms alone. Incorporating mental health evaluation into routine hypertension care could play a key role in reducing cardiovascular risk and improving long-term outcomes."
Reference:
Tu, Q., Lin, S., Hafiz, N., Hyun, K., Manandi, D., Zhao, E., Wu, H., Huang, Y., Ma, S., Zhang, Z., Zheng, J., & Redfern, J. (2025). Independent and joint associations of hypertension and depression with cardiovascular diseases and all-cause mortality: A population-based cohort study. Journal of Human Hypertension, 1-9. https://doi.org/10.1038/s41371-025-01045-1
