Key result
Isolated hypertension linked to ~6-point higher depression scores, unlike isolated HF or CAD.
Why the study?
Previous studies linking depression, anxiety, and stress to HTN, HF, and CAD often included patients with concomitant diseases, risking biased estimations.
Are hypertension, heart failure, and coronary artery disease independently associated with depression, anxiety, and stress when excluding concomitant diseases?
Cross-Sectional (n=400)
Are hypertension, heart failure, and coronary artery disease independently associated with depression, anxiety, and stress when excluding concomitant diseases?
Hypertension, but not heart failure or coronary artery disease without concomitant hypertension, is significantly associated with higher levels of depression, anxiety, and stress.
May prompt depression screening in isolated hypertension; leaves open causality and independent effects of HF or CAD.
Background Previous studies have emphasized the significant association between depression, anxiety, and stress and hypertension (HTN), heart failure (HF), and coronary artery disease (CAD). However, among included patients with HF or CAD in those studies, there were considerable proportions of patients with concomitant HTN and vice versa leading to some possible bias in final estimations. Therefore, we aimed to exclude those patients with concomitant diseases and reassess the association between these three prevalent cardiovascular diseases with three important psychological disorders. Methods In this cross-sectional study, 300 patients were evaluated, including 100 with HTN (without a history or concomitant HF or CAD), 100 with HF (without HTN or CAD), and 100 with CAD (without HTN or HF). Moreover, 100 healthy volunteers were considered as the control group. Depression Anxiety Stress Scale 21 was used to measure the magnitude of depression, anxiety, and stress. Result The average scores of 4.6, 9.1, 3.7, and 4.4 for depression, 3.9, 11.1, 4.1, and 3.6 for anxiety and 6.5, 13.6, 5.2, and 5.4 for stress were detected in control, HTN, CAD, and HF groups, respectively. The depression, anxiety, and stress scores of HTN group were significantly higher than the control (p < 0.05), CAD (p < 0.05) and HF (p < 0.05) groups; this is while these scores were not significantly different between other study groups (p > 0.05). Conclusion Our study demonstrated a significantly higher magnitude of psychological disorders in patients with HTN. However, their magnitude in patients with HF and CAD without concomitant HTN were similar to those in healthy participants.
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Namdar et al. (2020) conducted a cross-sectional in Hypertension, Heart Failure, Coronary Artery Disease (n=400). Isolated Hypertension vs. Healthy controls was evaluated on Depression score (DASS-21) (MD 5.7, 95% CI 3.7-7.7, p=<0.001). Isolated hypertension was associated with significantly higher depression scores compared to healthy controls (adjusted mean difference 5.7), whereas isolated heart failure and coronary artery disease were not.
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