OBJECTIVES: Previous studies have examined the association between depression and hypertension. This study aims to examine whether health status and health care costs differ between hypertensive patients with and without depression. METHODS: The study sample was all adult survey respondents with a self-reported diagnosis of hypertension from the MEPS (2002-2003). These respondents were also asked about the presence of conditions related to depression. Health status measures include SF-12 physical component summary (PCS) and SF-12 mental component summary (MCS) score, and EQ-5D utility score. Health care utilization was explored in the following categories: outpatient, inpatient, dental, and pharmacy. The impact of depression on health status or health care utilization was explored using multivariate linear regression models with depression as an independent dummy variable, after controlling for age, gender, ethnicity, marital status, income, and health insurance. All analyses are weighted to the US population by the personal level weights reported in the MEPS data set. RESULTS: Among a total of 5052 MEPS respondents having hypertension, 1962 reported having (38.84%) depression problems. These two groups (with and without depression) were comparable in age and ethnicity. Female hypertensive patients with lower income level or with Medicare or Medicaid coverage had a higher proportion of depression. In regression models, hypertensive patients with depression had worse health status: SF-12 PCS score (-5.6, p<0.0001), SF-12 MCS score (-13.5, p<0.0001), and EQ-5D utility score (-0.20, p<0.0001). Hypertensive patients with depression had higher utilization of outpatient ($415, p<0.0001) and pharmacy ($10, p<0.0001) services, but both groups had comparable expenditures in inpatient care ($0.09, p<0.0001) and dental service (-$23, p>0.05). CONCLUSION: In the U.S. population, hypertensive patients with depression had poorer health status and higher health care expenditure in outpatient services and prescription drug compared with those without depression. The difference in inpatient cost between these groups was very small.