Effect of Situational Anxiety and Depression on 24-Hour Ambulatory Blood Pressure Monitorization in Patients with Hypertension

Objective: To evaluate the effects of situational anxiety, stress and depression on 24-hour ambulatory blood pressure monitorization (ABPM) in patients with hypertension. Material and Methods: Three hundred twenty-six medically treated hypertensive patients were included in the study. According to their 24-hour ABPM results 162 patients were categorized as dipper hypertensives, 164 patients were categorized as non-dipper hypertensives. All patients completed self-report questionnaires which include General Health Questionnaire (GHQ-12), State-trait anxiety inventory (STAI) form TX-I and STAI form TX-II before ABPM. STAI FORM TX-I questionnaire was repeated after ABPM. Results: GHQ and STAI FORM TX-I score of the non-dipper group were statistically significantly higher than the dipper group. Following ABPM, there was a statistically significant decrease in STAI FORM TX-I score in non-dipper group. A positive correlation was found between age and STAI FORM TX-I score (r=0.531, p=0.0001). There were significant differences in GHQ-12 and STAI FORM TX-I scores among groups according to education level (F=6.175, p=0.003 and F=5.877, p=0.003, respectively). Post hoc analysis revealed that the significance was due to the differences between group 3 (university level) and group 1 and 2 (elementary school and high school level). STAI FORM TX-I scores of the patients differed significantly in terms of their socioeconomic status (F=5.9701, p=0.003). Patients with higher socioeconomic status had lower STAI FORM TX-I scores compared to the middle and poor socioeconomic status. Conclusion: Situational anxiety, especially in elderly, poor and lower-educated patients might be a factor for non-dipping phenomenon.