Anxiety and depression associated cardiovascular health behaviors among patients with hypertension

Background: Anxiety and depression in hypertensive patients may lead to poor blood pressure control and increases the risk of disease mortality. Lifestyle impacts depression and anxiety. This study aimed to assess cardiovascular health behaviors (CHBs) associated with co-morbid anxiety and depression among patients with hypertension.Methods: We included 488 hypertensive patients from Changsha, China. We measured anxiety and depression using the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS), respectively. CHBs (smoking, overweight/obesity, leisure physical activity (LPA), and fruit and vegetable consumption (FVC)) were assessed using the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) index. We compared anxiety and depression prevalence of participants in different socio-demographic, CHBs, co-morbidities, family histories, assessed risk factors and their biological synergistic interaction.Results: The proportion of not ideal in smoking, overweight/obesity, LPA, and FVC were 63.9%, 49.8%, 30.7%, 78.3%, respectively. Displaying comorbidity of HLP and not obtaining adequate amounts of LPA were risk factors for both anxiety and depression. The synergy interaction between obtaining secondary education or less and displaying comorbidity of hyperlipidemia (HLP) for anxiety (OR=5.238, 95% CI=2.784, 9.856), and between not obtaining adequate amounts of LPA and obtaining manual labor for depression (OR=7.164, 95% CI=3.553, 14.443) was statistically significant.Conclusion: Our study indicated that doctors should pay more attention to the psychiatric health of hypertensive patients at lower education levels and with second comorbidities. More importantly, patients with hypertension working on manual jobs need to pay closer attention to how they spend their leisure time and strengthen LPA.