Combo therapy improves outcome for heart and mind

A regimen that integrates treatments for High Blood Pressure (hypertension) and depression is better than the usual care for improving the outcomes of both conditions, according to the results of a pilot trial.

Sixty-four patients (50 to 80 years of age) with concomitant depression and hypertension who underwent 6 weeks of integrated care had significant improvements in their depressive symptoms and blood pressure compared with those were received the usual care.

The intervention involved an integrated care manager who collaborated with the various physicians treating the patients’ depression and hypertension, Dr. Hillary R. Bogner and Heather F. de Vries, from the University of Pennsylvania in Philadelphia, note in the Annals of Family Medicine. The intervention provided patients with an individualized program that fit within their social and cultural environment.

The improved depression symptoms and reduced blood pressure seen in the integrated care group may have resulted from enhanced medication compliance, the researchers suggest in their report.

After 6 weeks, 31 percent of the control patients were adherent (80 percent or greater) to their antidepressant and antihypertensive medications. In the integrated care group, 72 percent were adherent to their antidepressant medications and 78 percent were adherent to their antihypertensive medications, a statistically significant difference.

In this investigation, “integrating depression and hypertensive treatment was successful in improving patient outcomes,” the researchers conclude.

They add that “integrated interventions may be more feasible and effective in real-world practices, where there are competing demands for limited resources.”

SOURCE: Annals of Family Medicine, July/August 2008.