High baseline anxiety and depression independently predicted incident hypertension over 7 to 16 years, with high anxiety increasing risk in whites aged 45-64 years (RR 1.82; 95% CI 1.30-2.53).
Cohort (n=2,992)
Do symptoms of anxiety and depression increase the risk of incident hypertension in initially normotensive adults?
Symptoms of anxiety and depression are independent risk factors for the development of hypertension, highlighting the importance of mental health in cardiovascular disease prevention.
Effect estimate: RR 1.82 (95% CI 1.30-2.53)
OBJECTIVE: To test the hypothesis that symptoms of anxiety and depression increase the risk of experiencing hypertension, using the National Health and Nutrition Examination I Epidemiologic Follow-up Study. DESIGN: A cohort of men and women without evidence of hypertension at baseline were followed up for 7 to 16 years. The association between 2 outcome measures (hypertension and treated hypertension) and baseline anxiety and depression was analyzed using Cox proportional hazards regression adjusting for hypertension risk factors (age; sex; education; cigarette smoking; body mass index; alcohol use; history of diabetes, stroke, or coronary heart disease; and baseline systolic blood pressure). Analyses were stratified by race and age (white persons aged 25-44 years and 45-64 years and black persons aged 25-64 years). SETTING: General community. PARTICIPANTS: A population-based sample of 2992 initially normotensive persons. MAIN OUTCOME MEASURES: Incident hypertension was defined as blood pressure of 160/95 mm Hg or more, or prescription of antihypertensive medications. Treated hypertension was defined as prescription of antihypertensive medications. RESULTS: In the multivariate models for whites aged 45 to 64 years, high anxiety (relative risk RR, 1.82; 95% confidence interval CI, 1.30-2.53) and high depression (RR, 1.80; 95% CI, 1.16-2.78) remained independent predictors of incident hypertension. The risks associated with treated hypertension were also increased for high anxiety (RR, 2.36; 95% CI, 1.73-3.23) and high depression (RR, 1.89; 95% CI, 1.25-2.85). For blacks aged 25 to 64 years, high anxiety (RR, 2.74; 95% CI, 1.35-5.53) and high depression (RR, 2.99; 95% CI, 1.41-6.33) remained independent predictors of incident hypertension. The risks associated with treated hypertension were also increased for high anxiety (RR, 3.24; 95% CI, 1.59-6.61) and high depression (RR, 2.92; 95% CI, 1.37-6.22). For whites aged 25 to 44 years, intermediate anxiety (RR, 1.62; 95% CI, 1.18-2.22) and intermediate depression (RR, 1.60; 95% CI, 1.17-2.17) remained independent predictors of treated hypertension only. CONCLUSION: Anxiety and depression are predictive of later incidence of hypertension and prescription treatment for hypertension.
Bruce S. Jonas (1997) conducted a cohort in Hypertension (n=2,992). Symptoms of anxiety and depression was evaluated on Incident hypertension (blood pressure ≥160/95 mm Hg or prescription of antihypertensive medications) (RR 1.82, 95% CI 1.30-2.53). High baseline anxiety and depression independently predicted incident hypertension over 7 to 16 years, with high anxiety increasing risk in whites aged 45-64 years (RR 1.82; 95% CI 1.30-2.53).