Improving anxiety screening for adults with hypertension

Background: There is very limited literature specifically addressing anxiety and hypertension. This integrative review evaluated existing research on the topic of appropriate measurement of anxiety levels in adult patients with elevated blood pressure and explored implications for clinical practice. Methods: Inclusion criteria included published in English, published in medical or nursing journals, full text available, published between 2014 and 2024, and inclusion of adult participants only (ages 18 through 70 years). Exclusion criteria included only abstract available, published prior to 2014, and focused on pediatric participants. A comprehensive, systematic review of the literature was completed using PubMed, Embase, CINAHL, and Scopus databases with results uploaded to Covidence. Primary search terms were “anxiety” AND “screening” AND “hypertension” AND “intersectionality.” A hand search with Google Scholar and article citations was completed. The Johns Hopkins Nursing Evidence-Based Practice model level and quality grading criteria and the PRISMA guideline were utilized during the integrative review process>. Results: Between identifying studies from databases and the hand search, a total of 23 studies remained and were included as part of the final review. The following themes surfaced: 1) regular anxiety level screenings for patients with hypertension, 2) increased prevalence of anxiety disorder among individuals with hypertension, and 3) female sex as an independent risk factor for anxiety disorder in individuals with hypertension. Conclusion: Early identification and treatment of both anxiety and hypertension with early screenings are critically important for optimal patient outcomes. Longitudinal research, systematic reviews, and randomized controlled trials measuring the influence of anxiety on hypertension rates are needed.