What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Blood pressure variability (n=235). Intervention: Anxiety and depressive symptoms vs. Absence of anxiety and depressive symptoms. Primary outcome: Short-term BPV quantified by daytime systolic average real variability (ARV) (p=0.349).

What question did this study set out to answer?

This study examines the relationship between anxiety and depression symptoms and blood pressure variability in older outpatients.

May 11, 2026

Association Between Symptoms of Anxiety and Depression and Blood Pressure Variability in Older Outpatients

Key Result

Anxiety and depressive symptoms were not independently associated with short-term blood pressure variability in older outpatients (ARV 16.4 vs 15.5 mmHg for GAD-7 positive vs negative; p=0.349).

Key Points

This study examines the relationship between anxiety and depression symptoms and blood pressure variability in older outpatients.
Cross-sectional multicenter study involving outpatients aged ≥ 65 years undergoing 24-h ambulatory blood pressure monitoring in Italy.
Anxiety and depressive symptoms were assessed using GAD-7, STAI-Y1/Y2, and GDS-15 scales.
Short-term BPV quantified by daytime systolic average real variability, and white-coat effect defined as specified blood pressure differences.
Anxiety prevalence was 34.9% to 74.0% across scales; depressive symptoms were seen in 28.5% of participants.
No significant difference in blood pressure variability between patients with and without anxiety or depressive symptoms. WCE prevalence was 40.9% and higher in those without depressive symptoms (39.2% vs 23.9%, p = 0.039).

Study Design

Type

Cross-Sectional (n=235)

Multicenter

Yes

Structured PICO

Do anxiety and depressive symptoms increase short-term blood pressure variability and white-coat effect in older outpatients?

Population

235 outpatients aged ≥ 65 years (median age 76.4 years, 60.0% female) undergoing 24-h ambulatory blood pressure monitoring (ABPM) across Italian geriatric centers.

Intervention

Presence of anxiety and depressive symptoms (assessed with GAD-7, STAI-Y1/Y2 and GDS-15)

Comparator

Absence of anxiety and depressive symptoms

Outcome

Short-term blood pressure variability (quantified by daytime systolic average real variability [ARV]) and white-coat effect (WCE)surrogate

Anxiety and depressive symptoms are not independently associated with short-term blood pressure variability in older outpatients.

Main Result

Absolute Event Rate: 16.4% vs 15.5%

p-value: p=0.349

Abstract

INTRODUCTION: Blood pressure variability (BPV) predicts cardiovascular risk beyond average BP, but evidence on the role of anxiety/depression on BPV in older adults is limited. AIM: To evaluate the association of anxiety and depressive symptoms with short-term BPV and white-coat effect (WCE) in older outpatients undergoing ambulatory blood pressure monitoring (ABPM). METHODS: Cross-sectional multicenter study of outpatients aged ≥ 65 years undergoing 24-h ABPM across Italian geriatric centers. Anxiety and depressive symptoms were assessed with GAD-7, STAI-Y1/Y2 and GDS-15. Short-term BPV was quantified by daytime systolic average real variability (ARV). The office-daytime BP difference was calculated (ΔSBP and ΔDBP), and WCE was defined categorically as ΔSBP ≥ 20 mmHg and/or ΔDBP ≥ 10 mmHg. Multivariable models were adjusted for clinical and pharmacological confounders. RESULTS: Among 235 outpatients (median age 76.4 years, 60.0% female), anxiety prevalence varied widely by scale (GAD-7: 34.9%; STAI-Y1: 74.0%; STAI-Y2: 73.2%), while depressive symptoms were present in 28.5%. ARV did not significantly differ in patients screening positive or negative for anxiety (GAD-7: 16.4 vs 15.5 mmHg, p = 0.349; STAI-Y1: 16.2 vs 14.9 mmHg, p = 0.214; STAI-Y2: 16.2 vs 14.8 mmHg, p = 0.160), or between those with and without depressive symptoms (15.9 vs 15.8 mmHg, p = 0.902); also, after adjustment for potential confounders. WCE prevalence was 40.9% and was higher in participants screening negative for depressive symptoms (39.2% vs 23.9%, p = 0.039). ΔSBP tended to be higher in participants screening negative for anxiety (GAD-7: 7.6 vs 3.3 mmHg, p = 0.095) and depressive symptoms (GDS-15: 7.6 vs 2.6 mmHg, p = 0.065). CONCLUSIONS: Anxiety and depressive symptoms were not independently associated with short-term BPV in older outpatients. WCE/ΔSBP were generally higher, albeit non significantly, in participants without anxiety or depression. These findings suggest that psychological symptoms may contribute only modestly to short-term BP fluctuations in older adults.

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