Abstract

BACKGROUND:

Psychosocial stress can be the cause or the consequence of hypertension.

OBJECTIVE:

To study the association between hypertension and anxiety or depression in adults from Hong Kong, China.

SUBJECTS AND METHODS:

Patients with diagnosed hypertension (n=197) were recruited to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The control group comprised 182 normotensive subjects recruited using random telephone numbers.

RESULTS:

The score in the anxiety subscale (HADS-A) of the HADS correlated with age (r= -0.23, P<0.001) and sex (r=0.11, P=0.042), and was found to be higher in women. The score in the depression subscale (HADS-D) correlated with age (r=0.17, P=0.003) and hypertension (r=0.12, P=0.039), but not with sex (r=0.02, P=0.68). When the control subjects were matched for sex and age with the subjects with hypertension, the mean HADS-A score was 5.51+/-0.41 in 113 hypertensive subjects and 4.38+/-0.39 in 113 normotensive subjects (P=0.047). The mean HADS-D score was 5.56+/-0.39 in the hypertensive and 4.76+/-0.32 in the normotensive subjects (P=0.11). Multiple regression analysis using data from both groups indicated that the HADS-A score was related to the HADS-D score (beta=0.49, P<0.001), age (beta= -0.25, P<0.001) and sex (beta=0.12, P=0.01) (R(2)=0.28), whereas the HADS-D score was related to the HADS-A score (beta=0.48, P<0.001), age (beta=0.30, P<0.001), positive smoking status (beta=0.13, P=0.004) and lack of exercise habit (beta=0.12, P=0.008) (R(2)=0.31). Hypertension was related to waist circumference, history of parental hypertension and age (R(2)=0.38, P<0.001). Anxiety and depression scores were rejected as independent variables.

CONCLUSIONS:

Hypertension was associated with anxiety but not depression; however, age, history of parental hypertension and central obesity appeared to have a stronger association with hypertension in adults from Hong Kong.