Psychosocial Factors and Risk of Hypertension

Abstract

Context Although psychosocial factors are correlated, previous studies on risk factors for hypertension have typically examined psychosocial factors individually and have yielded inconsistent findings. Objective To examine the role of psychosocial factors of time urgency/impatience (TUI), achievement striving/competitiveness (ASC), hostility, depression, and anxiety on long-term risk of hypertension. Design, Setting, and Study Population A population-based, prospective, observational study using participant data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. A total of 3308 black and white adults aged 18 to 30 years (when recruited in 1985 and 1986) from 4 US metropolitan areas and followed up through 2000 to 2001. Main Outcome Measures Fifteen-year cumulative incidence of hypertension (systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or taking antihypertensive medication). Results The incidence of hypertension at year 15 was 15% from baseline and 13.6% from year 5. After adjusting for the same set of hypertension risk factors and each of the psychosocial factors of TUI, ASC, hostility, depression, and anxiety in 5 separate logistic regression models, higher TUI and hostility were significantly associated with risk of developing hypertension at 15-year follow-up for the total sample. Compared with the lowest score group, the adjusted odds ratio (OR) for TUI was 1.51 (95% confidence interval [CI], 1.12-2.03) for a score of 1; 1.47 (95% CI, 1.08-2.02) for a score of 2; and 1.84 (95% CI, 1.29-2.62) for a score of 3 to 4 (P for trend=.001). Compared with the lowest quartile group, the adjusted OR for hostility was 1.06 (95% CI, 0.76-1.47) for quartile 2; 1.38 (95% CI, 1.00-1.91) for quartile 3; and 1.84 (95% CI, 1.33-2.54) for quartile 4 (P for trend Ͻ.001). No consistent patterns were found for ASC, depression, or anxiety. Raceand sex-specific analyses and multivariable models with simultaneous adjustment for all 5 psychosocial factors and other hypertension risk factors had generally similar results. Conclusion Among young adults, TUI and hostility were associated with a doseresponse increase in the long-term risk of hypertension.

Classical Risk Factors and Inflammatory Biomarkers: One of the Missing Biological Links between Cardiovascular Disease and Major Depressive Disorder

“…In spite of antihypertensive treatments, hypertensive states according to JNC-7 criteria [ 28 ] were more frequent in CVD. In line with our results, Yan et al described a higher incidence of hypertension associated with higher depression rating scores in young adults [ 35 ].…”

Prevalence and Associated Factors of Prehypertension and Hypertension in Iranian Population: The Lifestyle Promotion Project (LPP)

“…Our finding is in contrast to the earlier report suggested that no anxiety or mild anxiety was associated with the higher prevalence of hypertension [39, 40]; however, it was consistent with the results of other studies [41, 42]. Epidemiological surveys of mental disorders in Iran reported the rates of mental problems between 20.5% and 21.5% and women had a relative risk of mental disorders of 1.632 compared with men [43].…”

Psychological Distress During Pregnancy and the Development of Pregnancy-Induced Hypertension: A Prospective Study

“…This explains why, in general, PIH is much less common in multiparous women. The fact that, in multiparous women, high levels of NA were associated with the development of PIH (adjusted for a history of PIH) is consistent with the findings in the general population showing that acute and sustained stress is associated with elevated blood pressure (16–18). It is interesting to note that multiparous women with high P-NA levels at early gestation had a miscarriage twice more often compared with the reference group (Table 4).…”