Depression and anxiety in different hypertension phenotypes: a cross-sectional study

Abstract

Background Hypertension is a major risk factor of cardiovascular mortality. Mood disorders represent a growing public health problem worldwide. A complex relationship is present between mood disorders and cardiovascular diseases. However, less data is available about the level of depression and anxiety in different hypertension phenotypes. The aim of our study was to evaluate psychometric parameters in healthy controls (Cont), in patients with white-coat hypertension (WhHT), with chronic, non-resistant hypertension (non-ResHT), and with chronic, treatment-resistant hypertension (ResHT). Methods In a cross-sectional study setup 363 patients were included with the following distribution: 82 Cont, 44 WhHT, 200 non-ResHT and 37 ResHT. The patients completed the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A). Results BDI points were higher in WhHT (7 (3–11)) and ResHT (6 (3–11.5)) compared with Cont (3 (1–6), p < 0.05). Similarly, HAM-A points were higher in WhHT (8 (5–15)) and ResHT (10.5 (5.25–18.75)) compared with Cont (4 (1–7), p < 0.05) and also compared with non-ResHT (5 (2–10), p < 0.05). ResHT was independently associated with HAM-A scale equal or above 3 points (Beta = 3.804, 95%CI 1.204–12.015). WhHT was independently associated with HAM-A scale equal or above 2 points (Beta = 7.701, 95%CI 1.165–18.973) and BDI scale equal or above 5 points (Beta = 2.888, 95%CI 1.170–7.126). Conclusions Our results suggest psychopathological similarities between white-coat hypertension and resistant hypertension. As recently it was demonstrated that white-coat hypertension is not a benign condition, our findings can have relevance for future interventional purposes to improve the outcome of these patients.

The association between depressive symptoms and masked hypertension in participants with normotension measured at research center

“…Previous studies reported the association of WCHT with depression, anxiety, mental stress, and introverted personality traits [ 9 , 10 , 12 , 29 ]. Nonetheless, few studies have evaluated the association between MHT and depression.…”

“…Mental status, including depression, anxiety, stress, and personality, reportedly could influence BP [ 9 – 13 ]. However, the association between MHT and depression remains unclear.…”

Hereditary Hemorrhagic Telangiectasia Associating Neuropsychiatric Manifestations with a Significant Impact on Disease Management—Case Report and Literature Review

“…Some researchers indicated that the neurovascular manifestations show an age-related penetrance with an increased prevalence of cerebral manifestations over the lifespan [ 41 , 45 ]. A large number of patients suffering from HHT are able to identify one or more traumatic events related to their disease that caused psychological distress; therefore, the longer they live and the more bleeding episodes they experience, the more mentally affected they may be [ 47 , 54 , 55 , 56 , 57 , 58 , 59 ]. Our patient has a long history of hypertension and a poor therapy adherence; therefore, the causality connection between high blood pressure and anxiety, depression, or even an evolution towards dementia cannot be excluded [ 54 , 55 ].…”