Subclinical Anxiety: Presence and Implications in Hypertensive Patients

Hypertension is increasing in prevalence both in developed and in developing countries. It is a major cause of morbidity and mortality, responsible for approximately one half of the health burden and costs worldwide. Its etiology is multi-factorial, with many genetic, environmental, and lifestyle factors playing a role. Psychosocial factors such as anxiety and depression also appear to impact its clinical expression and direction. Anxiety and hypertension frequently coexist. Patients with clinically diagnosed anxiety appear to suffer from not only a higher overall mortality compared to non-anxious people, but they also suffer from a higher incidence of cardiovascular diseases (CVD). In patients with diagnosed cardiovascular events, anxiety levels are high and prognosticate worse outcomes. Research suggests that subclinical anxiety exhibits similar cognitive, neurobiological, and behavioral components when compared to clinical anxiety. However, the presence of subclinical anxiety in hypertensive patients has not been studied well. Our study finds that a significant number of patients with hypertension suffer from subclinical anxiety. This finding has therapeutic and prognostic significance.