Hypertension and Anxiety: Comorbidity, Treatment, and Access to Resources

Hypertension and its comorbidity with anxiety disorders is a global concern even more prevalent in developing countries. There is limited data from low-income countries. Existing literature has consistently exhibited a positive association between hypertension and anxiety, although the directional dependency between the two conditions is difficult to be determined. Studies have suggested a reciprocal relationship between the two, with hypertension symptoms such as headaches, shortness of breath, fear of complications, and dizziness triggering feelings of anxiety. Similarly, the pre-existing presence of anxiety may induce temporary, yet dramatic spikes in blood pressure as well as long-term issues with hypertension. This paper provides a review of the widely investigated association between hypertension and anxiety and describes the impact that one condition has on the other in terms of psychological and physical functioning, and risk factors. Additionally, a discrepancy between prevalence, ability to control, and treatment between affluent and developing countries are discussed. The most common and effective pharmacological and psychotherapeutic treatments are presented and reviewed. Evidence- based interventions include mindfulness-based treatments such as MBSR and MBCT, ABBTs such as ACT, cognitive behavioral therapy (CBT), and motivational interviewing. Suggestions for future treatment options and management of both conditions are presented, with an emphasis on populations in developing countries. To address discrepancies in access to resources, urbanization, and high illiteracy rates, a global risk approach is presented.