IJCS | Volume 32, Nº4, July/August 2019

359 Table 3 - Regression coefficient, odds ratio (OR) and its 95% confidence interval of the variables included in the adjusted and unadjusted logistic regression analysis Variable Regression coefficient (RC) Standard error Odds ratio (OR) 95% CI p value Unadjusted Depression 0.823 0.433 2.28 0.98 - 5.32 0.06 Constant 0.276 - - - - Adjusted for diabetes mellitus Depression 0.731 0.441 2.08 0.86 - 4.93 0.09 Constant 0.093 - - - - Adjusted for body mass index Depression 0.977 0.479 2.66 1.04 - 6.79 0.04* Constant -3.00 - - - - Adjusted for physical activity level Depression 1.23 0.486 3.41 1.31 - 8.85 0.01* Constant 0.348 - - - - Adjusted for diabetes mellitus, BMI and physical activity level Depression 1.124 0.516 3.08 1.12 - 8.46 0.03* Constant -2.515 - - - - (*) Statistically significant at p ≤ 0.05. Araújo et al. Depression and hypertension in elders Int J Cardiovasc Sci. 2019;32(4):355-361 Original Article and hypertension. Follow-up studies have corroborated such relationship, since the presence of obesity increases by 1.55 times the odds to develop depression, just as depression increases 1.58 times the odds to develop obesity. 19-22 Therefore, a higher cardiovascular risk comes from the association of these conditions, i.e., obesity and depression. 18,23 The adoption of a physically active lifestyle has been pointed out as an effective behavioral intervention to treat depression symptoms. 24,25 Josefsson et al., 26 in a systematic review with meta-analysis on this issue, concluded that the use of exercise as an intervention generates positive results in mild-to-moderate depression. Blake et al. 27 stated that physical activity programs can achieve positive results in the treatment of depressive symptoms in the elderly. The recent study of Holmquist et al., 28 broadens the basis of these findings. In the cited study, the authors evaluated the association of depression with several lifestyle-related variables, previous illnesses and physical performance in the elderly. It was observed that depressed elders (GDS ≥ 5 points) were predominantly obese, diabetic, and physically less active (or had worse physical performance). In fact, these same variables may be associated with hypertension, and thus can influence the association between hypertension and depression. In this sense, two aspects are relevant: 1) the identification of depressive, obese, diabetic and insufficiently active elderly subjects can guide the screening of those prone to hypertension, since this set of factors among elders increases in 3.08 (1.12 - 8.46) times the odds of being hypertensive; 2) all the studied factors associated with hypertension and depression here are amenable to intervention; thus, as proposed by Blake et al., 27 preventive strategies focused on physical activity could represent an excellent strategy from the point of view of cost-effectiveness to prevent hypertension in depressed elderly people, since the level of physical activity increases 3.41 (1.31 - 8.85) times the odds of a depressed elderly subject being hypertensive.