Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies

Matthew Schuchman; Tammy M Brady; Dorey A Glenn; Katherine R Tuttle; Gabriel Cara-Fuentes; Rebecca V Levy; Agustin Gonzalez-Vicente; Fadhl M Alakwaa; Tarak Srivastava; Christine B Sethna

doi:10.1007/s40620-024-01919-6

Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies

J Nephrol. 2024 Mar 21. doi: 10.1007/s40620-024-01919-6. Online ahead of print.

Authors

Affiliations

¹ Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA.
² Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA.
⁵ Division of Nephrology, University of Washington School of Medicine, Spokane, WA, USA.
⁶ Section of Pediatric Nephrology, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA.
⁷ Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
⁸ Division of Pediatric Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
⁹ Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
¹⁰ Department of Internal Medicine, Nephrology Division, University of Michigan, Ann Arbor, MI, USA.
¹¹ Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA.
¹² Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA. csethna@northwell.edu.
¹³ Feinstein Institutes for Medical Research, Manhasset, NY, USA. csethna@northwell.edu.

PMID: 38512380
DOI: 10.1007/s40620-024-01919-6

Abstract

Introduction: The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies.

Methods: An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes.

Results: In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes.

Discussion/conclusion: Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.

Keywords: Blood pressure; Glomerular disease; Mental health; PROMIS.

Abstract

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