Association of Blood Pressure with Suicide Attempt in First-Episode Drug-Naive MDD: Anxiety Mediates.
TL;DR
Blood pressure parameters, particularly elevated SBP and DBP, significantly predict suicide attempt risk in MDD patients, with anxiety playing a partial mediating role, and the importance of blood pressure monitoring and anxiety management in suicide prevention strategies for MDD patients is highlighted.
Abstract
This study investigated the relationships between blood pressure parameters and suicide attempt risk in first-episode, drug-naive major depressive disorder (MDD) patients, and examined anxiety's mediating role. Blood pressure parameters were measured in 1,718 first-episode, drug-naive patients with MDD. Relationships with suicide attempt risk were analyzed using logistic regression with curve fitting and threshold effect analysis. Mediation analysis assessed anxiety's role. A U-shaped relationship existed between pulse pressure (PP) and suicide attempt risk (inflection point: 43 mmHg). Below this threshold, each 1 mmHg PP increase was associated with 6.5% lower risk (OR = 0.935, 95% CI: 0.897-0.974); above it, each 1 mmHg increase was associated with 7.1% higher risk (OR = 1.071, 95% CI: 1.036-1.107). Systolic (SBP) and diastolic blood pressure (DBP) showed J-shaped relationships with suicide risk (inflection points: 132 mmHg and 77 mmHg, respectively). No significant associations existed below these thresholds, while above them, each 1 mmHg increase in SBP and DBP was associated with 21.9% (OR = 1.219, 95% CI: 1.144-1.299) and 9.0% (OR = 1.090, 95% CI: 1.049-1.132) higher suicide attempt risk, respectively. Anxiety partially mediated the effects of PP (29.34%), SBP (31.89%), and DBP (35.75%) on suicide risk. Blood pressure parameters, particularly elevated SBP and DBP, significantly predict suicide attempt risk in MDD patients, with anxiety playing a partial mediating role. These findings highlight the importance of blood pressure monitoring and anxiety management in suicide prevention strategies for MDD patients.