The relationship between hypertension and anxiety or depression in Hong Kong Chinese

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

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

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.

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.

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.