Key result
Abnormal anxiety affects ~22% of hypertensive patients, linked to poor blood pressure control.
Why the study?
Although the relationship between hypertension and mental health has been examined in developed nations, limited information is available on the frequency and associated factors of depression and anxiety among hypertensive patients in developing nations including Pakistan.
Cross-Sectional (n=420)
No
Over one-third of hypertensive patients in this Pakistani cohort exhibited elevated anxiety or depression, underscoring the need for routine mental health screening in hypertension clinics, particularly among those with poor blood pressure control or comorbid CKD and diabetes.
Prevalence of anxiety and depression linked to poor BP control, CKD, and diabetes in Pakistani hypertensives; extends prior observations but remains hypothesis-generating.
Background: Even though the relationship between hypertension and mental health has been examined in developed nations, limited information is available from developing nations including Pakistan. Objective: To investigate frequency and associated factors of depression and anxiety among hypertensive patients. Methods: This cross-sectional study was undertaken at Department of Medicine and Allied, Chaudhary Muhammad Akram Teaching and Research Hospital Lahore from April 2025 to December 2025 enrolling 420 patients. Depression and anxiety were examined with Hospital Anxiety and Depression Scale (HADS). SPSS version 23.0 was employed for statistical analysis. Results: Mean age was 46.8±10.3 years and majority were female (74.8%). Mean HADS anxiety score was 5.6±5.4 with 92 (21.9%) patients in abnormal anxiety category. Multivariable linear regression analysis revealed CKD as an independent associated factor of anxiety (β=−4.721, 95% CI: −7.121 to −2.322, p<0.001), followed by diabetes (β=−2.179, 95% CI: −3.732 to −0.626, p=0.006), employment (β=−1.959, 95% CI: −3.327 to −0.591, p=0.005), poor hypertension control (β=1.500, 95% C:I 0.045-2.955, p=0.043) and family history of hypertension (β=1.866, 95% CI: 0.296-3.346, p=0.020). Mean HADS depression score was 5.7±4.5 with 76 (18.1%) patients in abnormal depression category. Multivariable linear regression analysis demonstrated male gender as significant independent predictor of depression (β=−2.948, 95% CI: −4.188 to −1.709, p<0.001), along with poor hypertension control (β=1.743, 95% CI 0.553-2.934, p=0.004), CKD (β=−2.784, 95% CI: −4.732 to −0.837, p=0.005) and diabetes (β=−1.591, 95% CI: −2.841 to −0.341, p=0.013). Conclusions: Over one-third patients had increased depression and anxiety levels, highlighting importance of routine screening for mental health issues and integration of management strategies into hypertensive care.
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Butt et al. (2026) conducted a cross-sectional in Hypertension (n=420). Poor hypertension control and clinical comorbidities (CKD, diabetes) vs. Well-controlled hypertension / absence of comorbidities was evaluated on Frequency and associated factors of abnormal anxiety and depression measured by the Hospital Anxiety and Depression Scale (HADS) (β=1.500 (anxiety with poor HTN control); β=1.743 (depression with poor HTN control), 95% CI 0.045-2.955, p=0.043). Among 420 hypertensive patients in Pakistan, 21.9% had abnormal anxiety and 18.1% had abnormal depression, with poor blood pressure control, CKD, and diabetes acting as independent predictors.
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