Background/Aims: Psychological conditions are increasingly linked with cardiovascular disorders. We aimed to examine the association between psychological distress and hypertension. Methods: We used data from the National Health Interview Survey for 2004-2013. Hypertension was self-reported and the 6-item Kessler Psychological Distress Scale was used to assess psychological distress (a score ≥13 indicated distress). We used a logistic regression model to test the assumption that hypertension was associated with psychological distress. Results: Among the study participants completing the survey (n = 288,784), 51% were female; the overall mean age (±SEM) was 35.3 ± 0.02 years and the mean body mass index was 27.5 ± 0.01. In the entire sample, the prevalence of psychological distress was 3.2%. The adjusted odds of reporting hypertension in psychologically distressed individuals was 1.53 (95% CI = 1.31-1.80, p = 0.01). Conclusion: The findings suggest that psychological distress is associated with higher odds of hypertension after adjusting for other risk factors for high blood pressure. Further studies are needed to confirm these findings and to elucidate the mechanisms by which stress increases hypertension risk.

Keywords:
Hypertension, Emotional distress, Kessler Psychological Distress Scale
1.
Lawes CM, Vander Hoorn S, Rodgers A; International Society of Hypertension: Global burden of blood-pressure-related disease, 2001. Lancet 2008;371:1513-1518.
2.
Davis K: Expenditures for Hypertension among Adults Age 18 and Older, 2010: Estimates for the US Civilian Noninstitutionalized Population. Statistical Brief No 404. April 2013. Agency for Healthcare Research and Quality, Rockville. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st404/stat404.shtml.
3.
Mozaffarian D, Benjamin EJ, Go AS, et al: Heart disease and stroke statistics - 2015 update: a report from the American Heart Association. Circulation 2015;131:e29-e322.
4.
Carroll D, Phillips AC, Gale CR, Batty GD: Generalized anxiety and major depressive disorders, their comorbidity and hypertension in middle-aged men. Psychosom Med 2010;72:16-19.
5.
Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS: Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med 2009;71:273-279.
6.
Hamer M, Batty GD, Stamatakis E, Kivimaki M: Hypertension awareness and psychological distress. Hypertension 2010;56:547-550.
7.
Ringoir L, Pedersen SS, Widdershoven JW, Pop VJ: Prevalence of psychological distress in elderly hypertension patients in primary care. Neth Heart J 2014;22:71-76.
8.
Footman K, Roberts B, Tumanov S, McKee M: The comorbidity of hypertension and psychological distress: a study of nine countries in the former Soviet Union. J Public Health (Oxf) 2013;35:548-557.
9.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959-976.
10.
Cornelius BL, Groothoff JW, van der Klink JJ, Brouwer S: The performance of the K10, K6 and GHQ-12 to screen for present state DSM-IV disorders among disability claimants. BMC Public Health 2013;13:128.
11.
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;14:184-189.
12.
Pratt LA, Dey AN, Cohen AJ: Characteristics of adults with serious psychological distress as measured by the K6 scale: United States, 2001-04. Adv Data 2007;(382):1-18.
13.
Parsons VL, Moriarity C, Jonas K, Moore TF, Davis KE, Tompkins L: Design and estimation for the national health interview survey, 2006-2015. Vital Health Stat 2 2014;(165):1-53.
14.
Kessler RC, Green JG, Gruber MJ, Sampson NA, Bromet E, Cuitan M, Furukawa TA, Gureje O, Hinkov H, Hu CY, Lara C, Lee S, Mneimneh Z, Myer L, Oakley-Browne M, Posada-Villa J, Sagar R, Viana MC, Zaslavsky AM: Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. Int J Methods Psychiatr Res 2010;14(suppl 1):4-22.
15.
Schuch JJ, Roest AM, Nolen WA, Penninx BW, de Jonge P: Gender differences in major depressive disorder: results from the Netherlands study of depression and anxiety. J Affect Disord 2014;156:156-163.
16.
Chou KL, Cheung KC: Major depressive disorder in vulnerable groups of older adults, their course and treatment, and psychiatric comorbidity. Depress Anxiety 2013;30:528-537.
17.
Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Ruan WJ, Huang B: Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2005;66:1205-1215.
18.
Foster J, Read D, Karunanithi S, Woodward V: Why do people drink at home? J Public Health (Oxf) 2010;32:512-518.
19.
Meltzer H, Bebbington P, Brugha T, Jenkins R, McManus S, Stansfeld S: Job insecurity, socio-economic circumstances and depression. Psychol Med 2010;40:1401-1407.
20.
McKenzie SK, Imlach Gunasekara F, Richardson K, Carter K: Do changes in socioeconomic factors lead to changes in mental health? Findings from three waves of a population based panel study. J Epidemiol Community Health 2014;68:253-260.
21.
McInerney M, Mellor JM, Nicholas LH: Recession depression: mental health effects of the 2008 stock market crash. J Health Econ 2013;32:1090-1104.
22.
Tampubolon G, Hanandita W: Poverty and mental health in Indonesia. Soc Sci Med 2014;106:20-27.
23.
Regier DA, Farmer ME, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ: One-month prevalence of mental disorders in the United States and sociodemographic characteristics: the Epidemiologic Catchment Area study. Acta Psychiatr Scand 1993;88:35-47.
24.
Schutte AE, Ware LJ, Huisman HW, Fourie CM, Greeff M, Khumalo T, Wissing MP: Psychological distress and the development of hypertension over 5 years in black South Africans. J Clin Hypertens (Greenwich) 2015;17:126-133.
25.
Footman K, Roberts B, Tumanov S, McKee M: The comorbidity of hypertension and psychological distress: a study of nine countries in the former Soviet Union. J Public Health (Oxf) 2013;35:548-557.
26.
Nijm J, Jonasson L: Inflammation and cortisol response in coronary artery disease. Ann Med 2009;41:224-233.
27.
Whitworth JA, Williamson PM, Mangos G, Kelly JJ: Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag 2005;1:291-299.
28.
Traustadóttir T, Bosch PR, Matt KS: Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women. Stress 2003;6:133-140.
29.
Tevie J, Shaya FT: Association between mental health and comorbid obesity and hypertension among children and adolescents in the US. Eur Child Adolesc Psychiatry 2015;24:497-502.
30.
Ul-Haq Z, Mackay DF, Pell JP: Association between self-reported general and mental health and adverse outcomes: a retrospective cohort study of 19,625 Scottish adults. PLoS One 2014;9:e93857.
31.
Nakaya N, Kogure M, Saito-Nakaya K, Tomata Y, Sone T, Kakizaki M, Tsuji I: The association between self-reported history of physical diseases and psychological distress in a community-dwelling Japanese population: the Ohsaki Cohort 2006 Study. Eur J Public Health 2014;24:45-49.
32.
Logan JG, Barksdale DJ, Carlson J, Carlson BW, Rowsey PJ: Psychological stress and arterial stiffness in Korean Americans. J Psychosom Res 2012;73:53-58.
33.
Hennekens CH, Hennekens AR, Hollar D, Casey DE: Schizophrenia and increased risks of cardiovascular disease. Am Heart J 2005;150:1115-1121.
34.
Broadbent E, Kydd R, Sanders D, Vanderpyl J: Unmet needs and treatment seeking in high users of mental health services: role of illness perceptions. Aust N Z J Psychiatry 2008;42:147-153.
35.
Shen C, Sambamoorthi U, Rust G: Co-occurring mental illness and health care utilization and expenditures in adults with obesity and chronic physical illness. Dis Manag 2008;11:153-160.
36.
Ravenell J, Ogedegbe G: Unconscious bias and real-world hypertension outcomes: advancing disparities research. J Gen Intern Med 2014;29:973-975.
37.
Prince M, Patel V, Saxena S, et al: No health without mental health. Lancet 2007;370:859-877.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.