Strict association between development of psychological conditions and hypertension incidence: A cross-sectional study

J Gen Fam Med. 2024 Apr 25;25(4):198-205. doi: 10.1002/jgf2.696. eCollection 2024 Jul.

Abstract

Background/aims: Previous studies indicated a significant association between mental disorders and cardiovascular diseases, including heart failure (HF) and coronary artery disease (CAD) with comorbidity hypertension (HTN), and vice versa, leading to a challenge in the final decision. To resolve this issue, we aimed to exclude comorbidities and further assessed to better find any association between mental disorders and cardiovascular diseases (CVD).

Methods: The cross-sectional study involved 300 participants: 100 with HTN (without HF or CAD), 100 with HF (without HTN or CAD), 100 with CAD (without HTN or HF), and 100 healthy individuals as a control group. To evaluate depression, anxiety, and stress levels, the Depression, Anxiety, and Stress Scale - 21 (DASS-21) was applied. For further analysis, the SPSS ver.20 was used.

Results: The analysis showed that the score of depression, anxiety, and stress was higher in the HTN patients compared to the control (p < 0.001), CAD (p < 0.001), and HF (p < 0.001) groups, respectively. However, no significant differences were observed between the other study groups. Notably, patients with HF and CAD without concurrent HTN had similar psychological distress levels to healthy participants.

Conclusion: The present study emphasized the higher prevalence of psychological distress in HTN patients and suggests a requirement for further research regarding the etiology involved in this association.

Keywords: anxiety; coronary artery disease; depression; heart failure; hypertension; stress.