Psychiatric Comorbidity in Essential Hypertension

Abstract

The prevalence of essential hypertension has continued to increase worldwide, and its consequences have remained a growing concern. A number of sociodemographic and clinical variables may however serve as key determinants of the extent to which it is associated with psychiatric comorbidity as well as impairment of quality of life. The aim of this study, therefore, was to determine the sociodemographic and clinical factors that may influence the level of psychiatric comorbidity and quality of life associated with persons with essential hypertension attending the general outpatient clinic of the University of Port Harcourt Teaching Hospital (UPTH). Following ethical approval and informed consent from the participants, 360 subjects making up the study group were recruited based on the study's inclusion and exclusion criteria. A pilot study was carried out. Subjects were further administered with the study's instruments including the socio-demographic/clinical questionnaire, GHQ-12, WHO Composite International Diagnostic Interview (WHOCIDI) and the WHOQOL-Bref. The data were analysed using the Statistical Package for Social Sciences version 16 statistical package. Confidence interval was set at 95%, while p-value of less than 0.05 was considered statistically significant. The study found a prevalence of psychiatric comorbidity of 64.4% among the hypertensives. Among the study group, there was no significant relationship between the presence of psychiatric comorbidity and age class (p = 0.350), gender (p = 0.22), level of education (p = 043), income class (p = 0.81) and occupation. Persons who were married were significantly more likely to have a psychiatric comorbidity (p = 0.001). There was also no significant relationships between age of onset of illness (p = 0.60), duration of illness (p = 0.73), duration of treatment (p = 0.82) and self-stigma (p = 0.15). The findings of this study support the impression that essential hypertension is a chronic debilitating illness, associated with psychiatric comorbidity and reduced quality of life, that is largely significantly influenced by a number of sociodemographic and clinical factors. The results support the call that the management of patients with

Psychological distress among people living with chronic medical illness and the general population, Northwest Ethiopia: A comparative cross-sectional study

“…Among people living with chronic medical diseases, the study showed findings similar with those of other studies carried out in Ethiopia (63.3%) [ 24 ], Pakistan (60.2%, [ 25 ], Nigeria (64.4%) [ 26 ], and Delhi India (58.7%) [ 27 ]. However, the magnitude of psychological distress in this study was higher than that in studies done in Southern Ethiopia (39.2%) [ 28 ], Addis Ababa, Ethiopia (53.1%) [ 29 ], India (50.8%) [ 30 ], Kenya (42.3%) [ 31 ] and Iran (14%) [ 32 ].…”

Hypertension and Anxiety: Comorbidity, Treatment, and Access to Resources

“…Furthermore, it was found that selfreported diagnosis of hypertension is commonly correlated with 12-month anxiety disorders and other comorbid mental disorders among South Africans as compared to those without hypertension. Delving further into socioeconomic and demographic risk factors, hypertension prevalence has been associated with low income, and specifically, the higher the income was in the cited study, the lower the prevalence of psychiatric comorbidity was in hypertension patients [1]. Thus, the risk of developing a mental disorder comorbid to hypertension appears to increase in lowincome populations.…”

“…In addition to health consequences and health-related risk factors, the growing prevalence of hypertension has led to a wide array of psychiatric comorbidities and thus, impairment of quality of life [1]. One of the most commonly diagnosed comorbidities of hypertension are anxiety disorders, which is the primary focus of this paper.…”

“…Furthermore, although anxiety may increase blood pressure in the short term, it can also have longterm implications by affecting the renin angiotensin system and decrease vascular variability such that vascular resistance persists over time and leads to hypertension [8]. From a neurobiological perspective, it can be understood that the presence of stress in the body increases cortisol levels, which results in "deposition of arteriosclerotic deposits in the intima of blood vessels" [1]. Thus, these depositions narrow the blood vessels over time which can lead to increased arterial pressure and hypertension.…”

“…Hypertension, otherwise referred to as high blood pressure, is a highly prevalent condition in which the force exerted by blood circulation against artery walls in the body is too high, resulting in an increased risk of cardiovascular disease, stroke, heart attack, and other life-threatening health complications [1]. Globally, this common condition has been the leading cause of premature death with some risk factors relating to age, sex, race, ethnicity, socioeconomic status, geographical location, and lifestyle choices.…”