Top

Published in:

01-10-2014 | Secondary Hypertension: Nervous System Mechanisms (J Bisognano, Section Editor)

Anxiety in the “Age of Hypertension”

Authors: James Brian Byrd, Robert D. Brook

Published in: Current Hypertension Reports | Issue 10/2014

Abstract

In the USA, hypertension affects one in three adults, and anxiety disorders are the most commonly diagnosed mental health disorders. Both hypertension and anxiety have been studied extensively. Yet, a full understanding of anxiety’s relationship to hypertension has been elusive. In this review, we discuss the spectrum of anxiety disorders. In addition, we consider the evidence for acute and long-term effects of anxiety on blood pressure. We review the effect on blood pressure of several “real-world” stressors, such as natural disasters. In addition, we review the effect of anxiety treatments on blood pressure. We explain the American Heart Association’s recent recommendations regarding meditation and other relaxation methods in the management of hypertension. We conclude that novel research methods are needed in order to better elucidate many aspects of how anxiety relates to hypertension.

Auden WH, Jacobs A. The age of anxiety: a Baroque Eclogue: Princeton University Press; 2011.

Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62(6):617–27. PMCID: Pmc2847357.PubMedCrossRefPubMedCentral

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circ. 2014;129(3):e28–e292.CrossRef

Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058. PMCID: Pmc2667673.PubMedCrossRefPubMedCentral

Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013;15(3):134–6. PMCID: Pmc3699411.PubMedCrossRefPubMedCentral

Kessler RC, Ormel J, Demler O, Stang PE. Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. J Occup Environ Med. 2003;45(12):1257–66.PubMedCrossRef

Sparrenberger F, Cichelero FT, Ascoli AM, Fonseca FP, Weiss G, Berwanger O, et al. Does psychosocial stress cause hypertension? A systematic review of observational studies. J Hum Hypertens. 2009;23(1):12–9.PubMedCrossRef

Spruill TM. Chronic psychosocial stress and hypertension. Curr Hypertens Rep. 2010;12(1):10–6. PMCID: Pmc3694268.PubMedCrossRefPubMedCentral

Gasperin D, Netuveli G, Dias-da-Costa JS, Pattussi MP. Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies. Cadernos de Saude Publica. 2009;25(4):715–26.PubMedCrossRef

10.•

Mann SJ. Psychosomatic research in hypertension: the lack of impact of decades of research and new directions to consider. J Clin Hypertens (Greenwich). 2012;14(10):657–64. This review focuses on factors limiting the impact of research on anxiety as it relates to hypertension.CrossRef

11.

Weiner IB, Craighead WE. The Corsini Encyclopedia of Psychology: Wiley; 2010.

12.

American Psychiatric Association APADSMTF. Diagnostic and statistical manual of mental disorders : DSM-5. 2013 [updated 2013; cited]; Available from: http://dsm.psychiatryonline.org/book.aspx?bookid=556.

13.

Ascher LM, Schotte DE. Paradoxical intention and recursive anxiety. J Behav Ther Exp Psychiatry. 1999;30(2):71–9.PubMedCrossRef

14.

Palatini P, Bratti P, Palomba D, Saladini F, Zanatta N, Maraglino G. Regular physical activity attenuates the blood pressure response to public speaking and delays the development of hypertension. J Hypertens. 2010;28(6):1186–93.PubMed

15.

Palatini P, Bratti P, Palomba D, Bonso E, Saladini F, Benetti E, et al. BP reactivity to public speaking in stage 1 hypertension: influence of different task scenarios. Blood Press. 2011;20(5):290–5.PubMedCrossRef

16.

Palatini P, Palomba D, Bertolo O, Minghetti R, Longo D, Sarlo M, et al. The white-coat effect is unrelated to the difference between clinic and daytime blood pressure and is associated with greater reactivity to public speaking. J Hypertens. 2003;21(3):545–53.PubMedCrossRef

17.

Lynch JJ, Long JM, Thomas SA, Malinow KL, Katcher AH. The effects of talking on the blood pressure of hypertensive and normotensive individuals. Psychosom Med. 1981;43(1):25–33.PubMedCrossRef

18.

White WB, Baker LH. Episodic hypertension secondary to panic disorder. Arch Intern Med. 1986;146(6):1129–30.PubMedCrossRef

19.

Davies SJ, Ghahramani P, Jackson PR, Noble TW, Hardy PG, Hippisley-Cox J, et al. Association of panic disorder and panic attacks with hypertension. Am J Med. 1999;107(4):310–6.PubMedCrossRef

20.

CDC. High blood pressure. [cited]; Available from: http://www.cdc.gov/bloodpressure/.

21.

Spruill TM, Pickering TG, Schwartz JE, Mostofsky E, Ogedegbe G, Clemow L, et al. The impact of perceived hypertension status on anxiety and the white coat effect. Ann Behav Med. 2007;34(1):1–9.PubMedCrossRef

22.

Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med. 1997;6(1):43–9.PubMedCrossRef

23.

Barringer 3rd TA. The tension in hypertension. Arch Fam Med. 1997;6(1):50–1.PubMedCrossRef

24.

Hildrum B, Mykletun A, Stordal E, Bjelland I, Dahl AA, Holmen J. Association of low blood pressure with anxiety and depression: the Nord-Trondelag Health Study. J Epidemiol Community Health. 2007;61(1):53–8. PMCID: 2465598.PubMedCrossRefPubMedCentral

25.

Hildrum B, Romild U, Holmen J. Anxiety and depression lowers blood pressure: 22-year follow-up of the population based HUNT study, Norway. BMC Public Health. 2011;11:601. PMCID: 3162525.PubMedCrossRefPubMedCentral

26.

Flaa A, Eide IK, Kjeldsen SE, Rostrup M. Sympathoadrenal stress reactivity is a predictor of future blood pressure: an 18-year follow-up study. Hypertens. 2008;52(2):336–41.CrossRef

27.

Steimer T. Animal models of anxiety disorders in rats and mice: some conceptual issues. Dialogues Clin Neurosci. 2011;13(4):495–506. PMCID: Pmc3263396.PubMedPubMedCentral

28.

Gerin W, Chaplin W, Schwartz JE, Holland J, Alter R, Wheeler R, et al. Sustained blood pressure increase after an acute stressor: the effects of the 11 September 2001 attack on the New York City World Trade Center. J Hypertens. 2005;23(2):279–84.PubMedCrossRef

29.

Petrazzi L, Striuli R, Polidoro L, Properzi G, Casale R, Pasqualetti P, et al. Changes in 24-h ambulatory blood pressure monitoring during the 2009 earthquake at L’Aquila. Am J Med. 2010;123(10):e1–3.PubMedCrossRef

30.•

Arcaya M, Glymour MM, Chakrabarti P, Christakis NA, Kawachi I, Subramanian SV. Effects of proximate foreclosed properties on individuals’ systolic blood pressure in Massachusetts, 1987 to 2008. Circ. 2014;129(22):2262–8. PMCID: Pmc4098719. This interesting study demonstrated a graded relationship between nearby foreclosures and blood pressure.CrossRef

31.

Yasunari K, Matsui T, Maeda K, Nakamura M, Watanabe T, Kiriike N. Anxiety-induced plasma norepinephrine augmentation increases reactive oxygen species formation by monocytes in essential hypertension. Am J Hypertens. 2006;19(6):573–8.PubMedCrossRef

32.

Piccirillo G, Viola E, Nocco M, Santagada E, Durante M, Bucca C, et al. Autonomic modulation and QT interval dispersion in hypertensive subjects with anxiety. Hypertens. 1999;34(2):242–6.CrossRef

33.

Saito II, Takeshita E, Murata K, Kawabe H, Saruta T. Serum cortisol in the white-coat phenomenon. Blood Press Monit. 1996;1(4):381–3.PubMed

34.•

Byrd JB, Powers JD, Magid DJ, Tavel HM, Schmittdiel JA, O’Connor PJ, et al. Detection and recognition of hypertension in anxious and depressed patients. J Hypertens. 2012;30(12):2293–8. This study in large cohort demonstrated earlier detection of elevated blood pressure in patients with anxiety and depression compared to other patients.PubMedCrossRef

35.

Hamer M, Batty GD, Stamatakis E, Kivimaki M. Hypertension awareness and psychological distress. Hypertens. 2010;56(3):547–50.CrossRef

36.

Pickering TG. Should white coat hypertension be treated? J Clin Hypertens (Greenwich). 2005;7(9):550–3.CrossRef

37.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98.PubMedCrossRef

38.

Hansen TW, Kikuya M, Thijs L, Bjorklund-Bodegard K, Kuznetsova T, Ohkubo T, et al. Prognostic superiority of daytime ambulatory over conventional blood pressure in four populations: a meta-analysis of 7,030 individuals. J Hypertens. 2007;25(8):1554–64.PubMedCrossRef

39.

Ogedegbe G, Pickering TG, Clemow L, Chaplin W, Spruill TM, Albanese GM, et al. The misdiagnosis of hypertension: the role of patient anxiety. Arch Intern Med. 2008;168(22):2459–65.PubMedCrossRef

40.

Davies SJ, Jackson PR, Ramsay LE, Ghahramani P, Palmer RL, Hippisley-Cox J. No evidence that panic attacks are associated with the white coat effect in hypertension. J Clin Hypertens (Greenwich). 2003;5(2):145–52.CrossRef

41.

Starkman MN, Zelnik TC, Nesse RM, Cameron OG. Anxiety in patients with pheochromocytomas. Arch Intern Med. 1985;145(2):248–52.PubMedCrossRef

42.

Mann SJ. Severe paroxysmal hypertension. An automatic syndrome and its relationship to repressed emotions. Psychosom. 1996;37(5):444–50.CrossRef

43.

Fogarty J, Engel CC, Russo J, Simon G, Katon W. Hypertension and pheochromocytoma testing: the association with anxiety disorders. Arch Fam Med. 1994;3(1):55–60.

44.

Kaplan NM. Anxiety-induced hyperventilation. A common cause of symptoms in patients with hypertension. Arch Intern Med. 1997;157(9):945–8.PubMedCrossRef

45.

Naschitz JE, Mussafia-Priselac R, Peck ER, Peck S, Naftali N, Storch S, et al. Hyperventilation and amplified blood pressure response: is there a link? J Hum Hypertens. 2005;19(5):381–7.PubMedCrossRef

46.

Stern RH. Nocebo responses to antihypertensive medications. J Clin Hypertens (Greenwich). 2008;10(9):723–5.CrossRef

47.

Davies SJ, Jackson PR, Ramsay LE, Ghahramani P. Drug intolerance due to nonspecific adverse effects related to psychiatric morbidity in hypertensive patients. Arch Intern Med. 2003;163(5):592–600.PubMedCrossRef

48.

Khatib R, Schwalm JD, Yusuf S, Haynes RB, McKee M, Khan M, et al. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies. PLoS One. 2014;9(1):e84238. PMCID: Pmc3893097.PubMedCrossRefPubMedCentral

49.

Bauer LK, Caro MA, Beach SR, Mastromauro CA, Lenihan E, Januzzi JL, et al. Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients. Am J Cardiol. 2012;109(9):1266–71.PubMedCrossRef

50.•

Bautista LE, Vera-Cala LM, Colombo C, Smith P. Symptoms of depression and anxiety and adherence to antihypertensive medication. Am J Hypertens. 2012;25(4):505–11. This study found decreased antihypertensive medication adherence in patients with at least mild anxiety and depression symptoms.PubMedCrossRefPubMedCentral

51.

Davies SJ, Ghahramani P, Jackson PR, Hippisley-Cox J, Yeo WW, Ramsay LE. Panic disorder, anxiety and depression in resistant hypertension—a case–control study. J Hypertens. 1997;15(10):1077–82.PubMedCrossRef

52.

Lenski D, Kindermann I, Lenski M, Ukena C, Bunz M, Mahfoud F, et al. Anxiety, depression, quality of life and stress in patients with resistant hypertension before and after catheter-based renal sympathetic denervation. EuroIntervention. 2013;9(6):700–8.PubMed

53.

Schmieder RE, Grassi G, Kjeldsen SE. Patients with treatment-resistant hypertension report increased stress and anxiety: a worldwide study. J Hypertens. 2013;31(3):610–5.PubMedCrossRef

54.

Grossman E, Nadler M, Sharabi Y, Thaler M, Shachar A, Shamiss A. Antianxiety treatment in patients with excessive hypertension. Am J Hypertens. 2005;18(9 Pt 1):1174–7.PubMedCrossRef

55.•

Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, et al. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association. Hypertens. 2013;61(6):1360–83. This scientific statements reviews the state of the art in non-pharmacological therapies for blood pressure lowering. Stress reduction techniques are discussed in detail.CrossRef

56.

Bradt J, Dileo C, Potvin N. Music for stress and anxiety reduction in coronary heart disease patients. Cochrane Database Syst Rev. 2013;12:Cd006577.PubMed

Title: Anxiety in the “Age of Hypertension”
Authors: James Brian Byrd
Robert D. Brook
Publication date: 01-10-2014
Publisher: Springer US
Published in: Current Hypertension Reports / Issue 10/2014
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-014-0486-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2014

Out-of-Office Blood Pressure Improves Risk Stratification in Normotension and Prehypertension People

Psychosocial Risk Factors for Hypertension: an Update of the Literature

Obstructive Sleep Apnea and Hypertension: a Critical Review

Mast Cell Infiltration and Obesity-Related Glomerulopathy: an Under-Recognized Disease Process and New Ways to Approach Treatment

Treatment of Hypertension and Metabolic Syndrome: Lowering Blood Pressure Is Not Enough for Organ Protection, New Approach-Arterial Destiffening

Ambulatory Blood Pressure Phenotypes and the Risk for Hypertension

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials