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Associations between depressive, anxiety, stress symptoms and elevated blood pressure: Findings from the CHCN-BTH

Han Qi1, Fu-Yuan Wen2, Yun-Yi Xie2

  • 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.

Journal of Affective Disorders
|August 20, 2023
PubMed

Insights

Anxiety symptoms are linked to a higher risk of elevated blood pressure, particularly in men. This study used longitudinal and Mendelian Randomization analyses to confirm the causal relationship between anxiety and hypertension.

Area of Science:

  • Cardiovascular Health
  • Mental Health Research
  • Epidemiology

Background:

  • Mental health conditions like depression, anxiety, and stress are increasingly recognized as potential contributors to physical health issues.
  • Understanding the specific relationship between psychological distress and cardiovascular risk factors, such as elevated blood pressure, is crucial for public health.
  • Previous research has suggested links, but robust evidence, especially causal inference, is needed.

Purpose of the Study:

  • To investigate the association between symptoms of depression, anxiety, and stress and the risk of developing elevated blood pressure.
  • To determine if these mental health symptoms have a causal effect on elevated blood pressure.
  • To analyze these relationships using both longitudinal cohort data and Mendelian Randomization techniques.

Main Methods:

  • Longitudinal cohort data from the CHCN-BTH study (2017-2021) involving 5624 participants.
  • Assessment of depressive, anxiety, and stress symptoms using the Depression-Anxiety-Stress Scale.
  • Statistical analysis using Cox proportional regression for longitudinal associations and two-sample Mendelian Randomization (IVW, weighted median, MR-Egger) for causal inference.

Main Results:

  • Participants with baseline anxiety symptoms showed a significantly higher risk of elevated systolic blood pressure (SBP ≥ 140 mmHg) or diastolic blood pressure (DBP ≥ 90 mmHg).
  • This association remained significant even after accounting for depression and stress, particularly in men and highly educated individuals.
  • Mendelian Randomization analysis supported a positive association between anxiety symptoms and elevated blood pressure, suggesting a potential causal link.

Conclusions:

  • Anxiety symptoms are independently associated with an increased risk of elevated blood pressure.
  • The findings, supported by both longitudinal and Mendelian Randomization analyses, provide evidence for a causal effect of anxiety on hypertension risk.
  • These results highlight the importance of addressing mental health, specifically anxiety, in cardiovascular disease prevention strategies.
Abstract

Keywords:
AnxietyDepressionElevated blood pressureMendelian randomizationStress

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