What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=262). Intervention: Female gender vs. Male gender. Primary outcome: Anxiety symptoms (OR 1.607, 95% CI 0.962-2.687, p=<0.05).

May 9, 2025Open Access

Mental health and hypertension: assessing the prevalence of anxiety and depression and their associated factors in a tertiary care population

Q: What are the key findings of this study?

Female gender was significantly associated with increased odds of anxiety (OR 1.607) among hypertensive patients, who exhibited an overall anxiety prevalence of 43.8% and depression prevalence of 51.3%.

GKGeetha KandasamyKing Khalid University TSThangamani SubramaniGrace College & Seminary MAMona AlmanasefKing Khalid University

Key Result

Female gender was significantly associated with increased odds of anxiety (OR 1.607) among hypertensive patients, who exhibited an overall anxiety prevalence of 43.8% and depression prevalence of 51.3%.

Study Design

Type

Cross-Sectional (n=262)

Multicenter

Structured PICO

Population

262 hypertensive patients on regular treatment, free of other major chronic conditions or psychiatric disorders, evaluated cross-sectionally for anxiety and depression.

Outcome

Prevalence of symptoms of anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS)patient reported

Approximately half of hypertensive patients in this tertiary care setting experience anxiety and depression, highlighting the need for routine mental health screening, particularly in those with uncontrolled blood pressure.

Main Result

Odds Ratio: 1.607 (95% CI 0.962–2.687)

p-value: p=<0.05

Limitations

Cross-sectional design cannot establish causality
Depression assessed through a self-report questionnaire rather than clinical diagnosis
Single blood pressure measurement may not reflect long-term control
Exclusion of patients with pre-existing psychiatric comorbidities may reduce generalizability

Abstract

Background Anxiety and depression are more common in those with hypertension. Identifying factors may lead to earlier assessment and treatment of depression and anxiety. So the study was aimed to assess the prevalence of anxiety and depression and examine the associated factors among hypertensive patients in a tertiary care hospital. Methods This cross sectional study was conducted over a six-months period (October 2023 to March 2024) in the Department of Medicine at Karuna Medical College Hospital, Kerala, India. The Hospital Anxiety and Depression Scale (HADS) was used to assess the symptoms of anxiety and depression. Multivariate logistic regression analysis was used to identify factors associated with anxiety and depression. Results Among 262 hypertensive patients, the prevalence of symptoms of anxiety were 43.8% and symptoms of depression were present in 51.3%. Female gender OR 1.607 95% CI (0.962–2.687) and BMI ≥ 25 OR 0.608 95% CI (0.361–1.024) were found to be significantly associated with anxiety ( p 0.05). Uncontrolled BP and stage1/stage 2 hypertension were found to be significantly associated with anxiety and depression ( p 0.05). Whereas factors like age (50 years), living with alone, unmarried/widow, unemployed/retired/house wife, illiterate, living in rural area and patients with comorbidities showed to be non-significantly association with anxiety and depression ( p 0.05) in patients with hypertension. Conclusion According to the findings, overall 50% of hypertensive patients experience anxiety and depression, which were significantly associated with uncontrolled BP, stage1/stage 2 hypertension, female gender and obesity. Healthcare providers can help identify mental health issues early, improving outcomes, with special attention needed for women with comorbidities and limited social support.

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