Psychosocial Risk Factors for Hypertension: an Update of the Literature

Abstract

A growing body of research demonstrates that psychosocial factors play an important role in the development of hypertension. Previous reviews have identified several key factors (i.e., occupational stress) that contribute to the onset of hypertension, however they are now outdated. In this review, we provide an updated synthesis of the literature from 2010 to April 2014. We identified 21 articles for inclusion in the review, of which there were six categories of psychosocial stressors: occupational stress, personality, mental health, housing instability, social support/isolation, and sleep quality. Sixteen of the studies reported an association between the psychosocial stressor and blood pressure. While several findings were consistent with previous literature, new findings regarding mediating and moderating factors underlying the psychosocial-hypertension association help to untangle inconsistences reported in the literature. Moreover, sleep quality is a novel additional factor that should undergo further exploration. Areas for future research based on these findings are discussed.

Dysregulated Blood Pressure: Can Regulating Emotions Help?

“…Like prior reviews [4,5,7,10,26-29,55], research from the last three years suggests that anxiety and depression are associated with a higher risk of hypertension. Although the associations appear to be in expected directions, less firm conclusions can be drawn regarding the specific role of anger and PPWB, with fewer methodologically rigorous studies published recently.…”

“…Due to space constraints, other relevant psychosocial factors such as discrimination and social support/isolation [2,5,6,9,10] were not considered. Articles were not included if they: 1) tested experimental tasks or psychosocial interventions; 2) considered hypertension as a risk factor for psychological distress; 3) were based on clinical/medical samples; or 4) monitored BP with a 24-hour ambulatory assessment, which does not provide information on hypertension onset specifically.…”

Sex differences in NMDA GluN1 plasticity in rostral ventrolateral medulla neurons containing corticotropin-releasing factor type 1 receptor following slow-pressor angiotensin II hypertension

“…Stress can influence blood pressure (Busnardo et al, 2013) and may contribute to hypertension (Cuffee et al, 2014). Corticotropin releasing factor (CRF) and its type 1 receptor (CRF 1 ) in the PVN and other brain areas have long been associated with both stress responses and with homeostatic regulation (Goncharuk et al, 2002; Ku et al, 1998; Smith et al, 1998).…”

Association Between Blood Pressure Lowering and Quality of Life by Treatment of Azilsartan

“…36,37) Relative to other CVD, such as CAD and CHF, the impact of HT on HR-QOL may be less, but it is reported that psychosocial factors contribute to the development of HT, and a higher level of BP induced more physical, emotional, and psychosocial impairments. 17,38) Since it often takes long-term treatment to manage HT, maintenance of adherence to treatment is critical to avoid treatment dropout. Therefore, physicians must evaluate patients' HR-QOL comprehensively from various points of view and follow them up in clinical settings.…”