The Impact of Mood and Anxiety Disorders on Incident Hypertension at One Year

Abstract

Background. Studies assessing the association between psychological factors and hypertension have been equivocal, which may reflect limitations in the assessment of psychological factors. Purpose. To assess the relationship between mood and anxiety disorders, measured using a psychiatric interview, and 1-year incident hypertension. Methods. 197 nonhypertensive individuals undergoing exercise stress testing at baseline provided follow-up data at 1 year. Baseline assessments included a structure psychiatric interview (PRIME-MD), physician diagnosis of hypertension, and measured blood pressure. At follow-up, hypertension status was assessed via self-reported physician diagnosis. Results. Having an anxiety disorder was associated with a 4-fold increase in the risk of developing hypertension (adjusted OR = 4.14, 95% CIs = 1.18–14.56). In contrast, having a mood disorder was not associated with incident hypertension (adjusted OR = 1.21, 95% CIs = 0.24–5.86). Conclusions. There are potential mechanisms which could explain our differential mood and anxiety findings. The impact of screening and treatment of anxiety disorders on hypertension needs to be explored.

Dysregulated Blood Pressure: Can Regulating Emotions Help?

“…Major depressive episode or dysthymia were associated with 20% greater odds of hypertension in the following year after adjusting for confounders including other psychiatric disorders. In the MOMSI study (described above), no association was found between mood disorders and incident hypertension [38]. Though inconsistent with previous findings, this may be due to the limited power (n cases =16) or to the heterogeneity of mood disorders category, which unlike other studies included bipolar disorder.…”

“…In another study in the meta-analysis, researchers completed an psychiatric interview among 190 middle-aged Canadian adults (MOMSI study) and considered risk of developing hypertension (n cases =16) over the following year [38]. Individuals with anxiety disorders had 7.25 higher odds (95%CI=1.90-27.74) of having physician-diagnosed hypertension or antihypertensive medication at follow-up, after adjusting for standard covariates, psychotropic medication, and comorbid mood disorder.…”

“…Overall, despite some mixed results [38,41], recent findings suggest a positive association between depressive symptoms or disorder and high BP [7,37,39,44]. A meta-analysis published in 2012 (9 prospective studies; N =22,367) found that depression or depressive symptoms was associated with a 42% higher risk of incident hypertension [7].…”

“…If the higher prevalence of anxiety/depression results from including individuals with milder symptoms, and if those less distressed individuals are less likely to develop hypertension, they thereby dilute the apparent risk associated with distress. Furthermore, participants with lower-to-moderate levels of psychological distress may be less likely to consult a physician for their overall well-being, and therefore less likely to have their BP checked [38,39], hence possibly driving results towards the null. Comparably, definitions/measurements of hypertension are highly heterogeneous (e.g., self-reported diagnosis, antihypertensive medication, SBP or DBP thresholds either jointly or separately).…”

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

“…Individuals with anxiety have a higher risk of hypertension than those without [39, 40]. Previous studies have reported that prevalence of anxiety is 9.5% in hypertensive patients [41].…”