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Detection and recognition of hypertension in anxious and depressed patients

James B Byrd1, J David Powers, David J Magid

  • 1Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109-2800, USA. jbbyrd@umich.edu

Journal of Hypertension
|October 4, 2012
PubMed

Insights

Patients with anxiety and depression had earlier detection of elevated blood pressure (BP). However, hypertension recognition (diagnosis or treatment) was similar or delayed, indicating potential disparities in care for these patients.

Area of Science:

  • Cardiovascular Medicine
  • Psychiatry
  • Health Services Research

Background:

  • Effective hypertension management relies on timely detection of elevated blood pressure (BP) and subsequent recognition through diagnosis or treatment.
  • Patients with comorbid mental health conditions like depression and anxiety may experience unique challenges in healthcare access and management.
  • Understanding disparities in hypertension care for these populations is crucial for improving cardiovascular outcomes.

Purpose of the Study:

  • To investigate potential disparities in the detection of elevated BP and recognition of hypertension among patients with comorbid depression and anxiety.
  • To compare the time to BP detection and hypertension recognition in patients with and without these mental health diagnoses.

Main Methods:

  • Utilized data from the Cardiovascular Research Network Hypertension Registry (2002-2006).
  • Conducted multivariable survival analysis to assess time-to-detection and time-to-recognition of hypertension.
  • Adjusted for factors including primary care visit rates and other clinical variables in a cohort of 168,630 incident hypertension patients.

Main Results:

  • Earlier detection of elevated BP was observed in patients with anxiety and depression (aHR 1.30, 95% CI 1.26-1.35).
  • Hypertension recognition within 12 months was similar (aHR 0.94, 95% CI 0.89-1.00) or delayed in patients with anxiety (aHR 0.93, 95% CI 0.88-0.99) and depression (aHR 0.93, 95% CI 0.90-0.97) compared to those without these conditions.
  • These findings highlight a divergence between BP detection and subsequent hypertension management.

Conclusions:

  • While elevated BP detection is faster in patients with anxiety and depression, the subsequent diagnosis and treatment initiation are not improved and may be delayed.
  • Unidentified factors likely contribute to these disparities in hypertension recognition, necessitating further investigation.
  • Clinical practice should address potential barriers to timely hypertension diagnosis and treatment in patients with mental health comorbidities.
Abstract

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