American journal of hypertension
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Clinical trials have provided convincing evidence that blood pressure (BP) lowering treatment reduces the risk of cardiovascular disease (CVD) and total mortality. The objective of this study was to examine the association of hypertension treatment, control, and BP indexes with all-cause and cardiovascular mortality among US adults with hypertension. ⋯ This study indicates that uncontrolled and untreated hypertension was associated with increased risk of total and cardiovascular mortality among the general hypertensive population.
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Depression has been found to predict the incidence of hypertension and other adverse cardiovascular events in prospective studies. Insomnia and short sleep duration, which are typical symptoms of depression, have also been shown to increase the risk for hypertension incidence. Insomnia is associated with increased activation of the hypothalamic-pituitary-adrenal axis, and short sleep duration raises average 24-h blood pressure, which over time could lead to structural adaptations that gradually reset the entire cardiovascular system to operate at an elevated pressure equilibrium. No previous published population studies have examined whether insomnia and sleep duration mediate the relationship between depression and hypertension incidence. ⋯ These results suggest the hypothesis that treatment of sleep problems in middle-aged individuals suffering from depression could reduce their risk for developing hypertension, and its vascular and cardiac complications.