The psychosocial determinants of hypertension

Kaplan, Mark S.; Nunes, Amanda Naves

doi:10.1016/s0939-4753(03)80168-0

Cited by 85 publications

(62 citation statements)

References 73 publications

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“…Because hypertensive patients in the present study had significantly elevated BAI scores, anxiety might have a role in the pathogenesis of hypertension (Kaplan and Nunes 2003). Our data are also compatible with the study in which oral diazepam (5 mg) and captopril (25 mg) were compared in two similar groups with excessive hypertension (Grossman et al 2005).…”

Section: Discussionsupporting

confidence: 91%

Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain

Vural¹,

Şatıroğlu²,

Akbas

et al. 2007

Tohoku J. Exp. Med.

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Psychological variables, such as depression and anxiety, are known as independent risk factors for coronary artery disease (CAD), suggesting the interaction of psychological and physiological factors in the development of CAD. In the present study, we analyzed the possible association between depressive and anxiety symptoms and major atherosclerotic risk factors in patients with chest pain warranting coronary angiography. The patients without CAD (n = 159) and those with CAD (n = 155) were evaluated for the severity of depression and anxiety by the symptom scales; high scores indicate severe symptoms. Age, male/female ratio, prevalence of diabetes mellitus (DM), and depression level were significantly higher in the CAD group. Among a total of 314 patients with chest pain, the mean depression score was higher in patients with DM (16.01 ± 8.12 vs 13.01 ± 9.6, p = 0.01) and those with hypercholesterolemia (15.43 ± 9.61 vs 12.53 ± 9.61, p = 0.02). The mean anxiety score was also higher in patients with DM (20.81 ± 12.85 vs 16.51 ± 12.09, p = 0.008), hypercholesterolemia (20.67 ± 13.11 vs 15.29 ± 11.36, p = 0.002), or hypertension (20.74 ± 12.94 vs 14.1 ± 10.8, p = 0.001). Thus, DM and hypercholesterolemia are associated with depression and anxiety, while hypertension is only related to anxiety. In contrast, smoking and family history of atherosclerosis are not related to depression and anxiety scores. These results suggest depression and anxiety symptoms may contribute to the development and progression of CAD, especially in patients with DM or hypercholesterolemia.depression; anxiety; psychological tests; atherosclerosis risk factors; coronary artery disease

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Section: Discussionsupporting

confidence: 91%

Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain

Vural¹,

Şatıroğlu²,

Akbas

et al. 2007

Tohoku J. Exp. Med.

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“…Previous reports suggest an inverse association between hypertension and socioeconomic status, represented by education and/or income. 14,17,39 We observed the same, with a lower prevalence among those with higher education or more spacious housing. However, in the adjusted analysis, only housing remained significant.…”

Section: Discussionsupporting

confidence: 64%

Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore

et al. 2010

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A comprehensive picture of the management of hypertension in the increasing elderly population in Singapore is lacking. In this study, we assess the prevalence and correlates of hypertension and of awareness, treatment and control of hypertension among 4494 elderly Singaporeans (X60 years) participating in a recent representative survey. The weighted prevalences of hypertension (systolic blood pressure X140 mm Hg or diastolic blood pressure X90 mm Hg or current use of antihypertension medication) and of awareness, treatment and control of hypertension were assessed. We assessed the extent of association of these outcomes with socio-demographic (age, gender, ethnicity, education, housing type, living arrangement and social participation) and health (body mass, diabetes and cognitive status) variables using multivariable logistic regression. Nearly three-fourths (73.9%) of participants were found to have hypertension. Of this number, 30.8% were unaware that they had hypertension, 32.0% were not being treated for the disease and 75.9% had suboptimal control of their blood pressure. Among those aware of their hypertension, only 1.9% were untreated. However, nearly two-thirds (64.5%) of treated hypertensives had suboptimal control. Age, gender, ethnicity, education, housing type, body mass and diabetes were significantly correlated with lack of awareness, treatment and control of hypertension. Although the specific 'at-risk' subgroups varied by the outcome, men and Malays had consistently higher odds for all three unfavorable outcomes. There is a need to improve awareness, treatment and especially control of hypertension among elderly Singaporeans. Primary and secondary prevention efforts targeting the elderly and their primary health-care providers are called for, as are regular data collection efforts based on representative samples.

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“…Stress is a process in which environmental demands tax or exceed one's adaptive capacity, resulting in physiological changes that may place the individual at risk for disease over time (1)(2)(3)(4)(5)(6)(7). Chronic stress may manifest itself in various ways including increased anxiety, depressive symptoms, hostility and poor sleep quality, all which independently predict essential hypertension (EH), cardiovascular disease (CVD), metabolic syndrome and type 2 diabetes (1)(2)(3)(4)(5)(6)8).…”

Section: Introductionmentioning

confidence: 99%

Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure

Sieverdes

Adams

Nemeth

et al. 2017

mHealth

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Background: Chronic stress is an independent risk factor for essential hypertension (EH), cardiovascular disease (CVD), and is sometimes confronted by mal-adaptive coping behaviors (e.g., stress eating, excessive alcohol consumption, etc.). Pre-essential hypertension (preEH) is the leading predictor of future EH status.Breathing awareness meditation (BAM) can result in clinically beneficial blood pressure (BP) reductions, though face-to-face sessions presents barriers to reach those in need. The purpose of this study was to identify if a culturally tailored approach is needed in the design and preferences between groups of preEH African American and White adults toward using a smartphone BAM app, the Tension Tamer (TT) app.Methods: TT includes audio delivered BAM instructions, real-time heart rate, feedback graphs and motivational reinforcement text messaging. Questionnaires and two focus groups each of African American and White adults, [n=34, mean age =43.1 years, (SD 13.8 years), 44.1% African American] were conducted to understand stress, EH knowledge, app usage along with feedback from a hands-on demonstration of TT.Grounded theory using NVivo 10 was used to develop themes and combined with the questionnaires in the analysis.Results: No racial differences were found in the analysis including app use scenarios, preferences, knowledge, technology use or the attitudes and acceptance toward mobile health (mHealth) programs.Reported stress was high for African Americans [PSS-4: mean 6.87 (SD 3.3) versus mean 4.56 (SD 2.6); P=0.03]. Four main themes were found: (I) stress was pervasive; (II) coping strategies were both positive and negative; (III) BAM training was easy to incorporated; and (IV) tracking stress responses was useful.Responses suggest that additional personalization of app interfaces may drive ownership and adherence to protocols. Measures and reports of heart rate monitoring while in session were favorably viewed with low issues with confidentiality or trust issues on collected session data. Conclusions:Results suggest that a culturally tailored approach may be unnecessary in the design of BAM apps.Further investigation is warranted for other racial groups, age ranges, and disease conditions.

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The psychosocial determinants of hypertension

Cited by 85 publications

References 73 publications

Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain

Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain

Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore

Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure

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