Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults

Abstract

Introduction Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension. Aim We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017–2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status. Methods Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis. Results A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41–5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42–4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22–4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05–3.38; P = 0.040) anxiety symptoms were more likely to have hypertension. Conclusions Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.

Smoking and Depression Risk Reduction in a Primary Care Setting

“…Although some studies found associations between chronic diseases, for example, hypertension and diabetes mellitus, and risk of or worsening depression, 27 , 28 our data did not show any significant associations between presence of chronic diseases and worsening depression risk. Our relatively small sample size might be partly accountable for that.…”

Association of depression and anxiety with uncontrolled hypertension: A cross-sectional study in Southwest Nigeria

“…[ 4 ] This reaffirms that anxiety and depression are common comorbidities among patients who have hypertension. [ 4 23 44 ] In addition, depression and anxiety were found among middle-aged adults and the elderly and this was consistent with the findings of a study in Afghanistan among adults with hypertension. [ 45 ] The study attributed this finding to the poor level of mental health services and facilities, in addition to the delay in accessing health care due to cost, especially in LMICs resulting in the challenge of diagnosing depression and anxiety at their onset among younger age.…”

“…In hypertensive patients, the relationship between hypertension and depression is quite unclear as some medications may also potentiate depression, while patients in a depressed state may also lose interest in taking medications and consequently have uncontrolled blood pressure. [ 21 ] Some large studies and studies conducted in the USA showed the presence of anxiety and/or depression among hypertensive patients,[ 22 23 ] and the presence of anxiety increased the odds ratio of hypertension. [ 24 25 ] Studies conducted in Nigeria, Ghana, and Ethiopia showed that a high proportion of the respondents who had hypertension also had symptoms of depression and anxiety.…”

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“…Moreover, respondents who reported occasional experiences of depressive feelings demonstrated an increased likelihood of hypertension, even if these occurrences were infrequent. Similarly, participants who reported experiencing daily or weekly anxiety were also more prone to having hypertension [56].…”