Influence of Depression on Antihypertensive Medication Adherence and Blood Pressure Control in Two Reference Hospitals in Cameroon: A Cross-Sectional Study

Hypertension is a major public health problem worldwide, and particularly in developing countries where it encompasses high rates of morbidity and mortality. Uncontrolled hypertension explains these rates of morbidity and mortality and may be more frequent in case of depression. This study aimed to assess the influence of depression on antihypertensive medication adherence and blood pressure control in Cameroon. We conducted a cross-sectional study in two reference hospitals in Cameroon from November 2023 to August 2024. We included hypertensive patients of 21 years or more treated with medications for at least 3 months. Depression was diagnosed with the Patient Health Questionnaire 9. Medication adherence was assessed using the Girerd questionnaire and blood pressure control through a 24 hours ambulatory blood pressure monitoring. We used the χ2 test to measure the association between categorical variables and the Spearman coefficient for correlation between quantitative variables. P values < 0.05 were considered as statistically significant. We included 70 patients (51.4% of women) with a median age of 57 years [49 – 65]. The median duration of hypertension was 60 months [24 – 120]. We found respectively 35.7%, 47.1%, 14.3% and 2.9% of monotherapy, dual, triple and quadruple combination therapy. There were respectively 60% and 20% of uncontrolled hypertension and poor medication adherence. Depression was present in 27.1% of participants. It was significantly associated to poor medication adherence [OR = 8.28, 95% CI (2.28 – 30.06); p = 0.001], but not to uncontrolled hypertension [OR = 1.64, 95% CI (0.54 – 5.01); p = 0.380]. Depression is frequent in hypertensive patients seen in the outpatient units of the Yaoundé and Garoua General Hospitals. It increases the risk of poor medication adherence with a tendency to uncontrolled hypertension.