Background: Hypertension has been linked to several psychological factors, including depression, but the relation between hypertension incidence and depressive symptoms has not been adequately examined.

Although BP reactivity to all physical and mental stressors used in this study did not consistently predict 5-year change in BP in this young cohort, the results indicate that reactivity to a video game stressor predicts 5-year change in BP and early hypertension among young adult men. These findings are consistent with other studies showing the usefulness of stressors producing a primarily beta-adrenergic response in predicting BP change and hypertension. The results may be limited by the shortened initial rest and recovery periods used in the CARDIA protocol.

Depressive symptoms are associated with subsequent unemployment and loss of family income among working young adults. Socioeconomic indicators, such as income and employment, should be considered in evaluating the potential benefits of treatment for patients with depressive symptoms.

OBJECTIVE -The epidemiology of peripheral vascular disease has rarely been studied in non-European populations. The purpose of this study was to determine the prevalence and risk factors of peripheral vascular disease (PVD) among South Indians. RESEARCH DESIGN AND METHODS -The Chennai Urban PopulationStudy is an epidemiological study involving 2 residential areas in Chennai in South India. Of the 1,399 eligible subjects (Ն20 years of age), 1,262 (90.2%) participated in the study. All of the study subjects underwent an oral glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes. Peripheral Doppler studies were performed on 50% of the study subjects, and PVD was defined as an ankle-brachial index (ABI) Ͻ0.9.RESULTS -The prevalence rates of PVD were 2.7, 2.9, and 6.3% in individuals with NGT, IGT, and diabetes, respectively. The overall prevalence rate was 3.2%. Known diabetic subjects had a higher prevalence of PVD (7.8%) compared with newly diagnosed diabetic subjects (3.5%). PVD was uncommon until middle-age and then the prevalence rate increased dramatically. Univariate regression analysis showed age Ͼ50 years (odds ratio [OR] 6.3, 95% CI 2.1-20.6, P Ͻ 0.001) and hypertension (OR 2.7, 0.9-7.3, P = 0.08) to be associated with PVD, whereas smoking and serum lipid levels showed no association. Multivariate regression analysis identified age as the most significant risk factor for PVD. Of the 90 subjects who had coronary artery disease (CAD), only 6 had PVD, and the positive predictive value of the ABI for CAD was only 30%.CONCLUSIONS -The prevalence of PVD in this urban South Indian population is considerably lower than that reported in European and U.S. studies and is in marked contrast to the high prevalence rate of CAD reported in this population.