Anxiety and Depression Prevalence in Essential Hypertensive Patients is there an Association with Arterial Stiffness

Background: The aim of the present study was to access the prevalence of anxiety and depression among essential hypertensive patients in different stages of hypertension compared to normotensives. Subjects were free of any psychiatric illness. Further evaluation of arterial stiffness was carried out and attempt to correlate with anxiety and depression was made. Materials and Methods: The study comprised of 127 participants who were divided in three groups based on the stage of hypertension; Group 1 (n=33 patients with stage 1 HTN), group 2 (n=30 patients with stage 2 HTN) and group 3 (n=30 patients with stage 3 HTN). The assessment of depression was made by means of the Becks Depression Inventory, BDI scale. Patients were further evaluated for anxiety and depression symptoms using the Hospital Anxiety and Depression, HADS scale. The cardio-ankle vascular index (CAVI) was used to assess arterial stiffness in all participants, whereas stage 1, 2 and 3 hypertensives were all subjected to 24 h ambulatory blood pressure monitoring. Results: There was a significant (p<0.001) increase in prevalence of depression as assessed by the BDI scale as the stages of hypertension evolved. Similarly, an increase (p<0.001) in both anxiety and depression, assessed by means of HADS scale, among the 3 stages of hypertension was noted. Finally, assessment of the arterial stiffness indices CAVIR and CAVIL was performed and demonstrated that there was a significant increase (p<0.001) in their values as HADS-A, HADS-D and BDI score increased. Conclusion: This prospective study demonstrated a clear burden of both anxiety and depression in higher levels of hypertension compared to normotensives. Furthermore, anxiety and depression are both linked to higher arterial stiffness levels among essential hypertensive patients irrespectively of the blood pressure levels.