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. 2015 Apr 22:11:1121-30.
doi: 10.2147/NDT.S77710. eCollection 2015.

Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies

Yu Pan  1 , Wenpeng Cai  2 , Qi Cheng  3 , Wei Dong  2 , Ting An  4 , Jin Yan  2
Affiliations

Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies

Yu Pan et al. Neuropsychiatr Dis Treat. .

Abstract

Background: Epidemiological studies have repeatedly investigated the association between anxiety and hypertension. However, the results have been inconsistent. This study aimed to summarize the current evidence from cross-sectional and prospective studies that evaluated this association.

Methods: Seven common databases were searched for articles published up to November 2014. Cross-sectional and prospective studies that reported an association between the two conditions in adults were included. Data on prevalence, incidence, unadjusted or adjusted odds ratios or hazard ratios, and 95% confidence intervals (CIs) were extracted or calculated by the authors. The pooled odds ratio was calculated separately for cross-sectional and prospective studies using random-effects models. The Q test and I2 statistic was used to assess heterogeneity. A funnel plot and modified Egger linear regression test were used to estimate publication bias.

Results: The search yielded 13 cross-sectional studies (n=151,389), and the final pooled odds ratio was 1.18 (95% CI 1.02-1.37; P Q<0.001; I (2)=84.9%). Eight prospective studies with a total sample size of 80,146 and 2,394 hypertension case subjects, and the pooled adjusted hazard ratio was 1.55 (95% CI 1.24-1.94; P Q<0.001; I (2)=84.6%). The meta-regression showed that location, diagnostic criteria for anxiety, age, sex, sample size, year of publication, quality, and years of follow-up (for prospective study) were not sources of heterogeneity.

Conclusion: Our results suggest that there is an association between anxiety and increased risk of hypertension. These results support early detection and management of anxiety in hypertensive patients.

Keywords: anxiety disorder; epidemiological association; human; hypertension; meta-analysis.

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Figures

Figure 1
Figure 1
Flow diagram of studies selection in meta-analysis.
Figure 2
Figure 2
Random effects meta-analysis of cross-sectional studies of the association between anxiety and hypertension (13 studies included). Note: Weights are from random effects analysis. Abbreviations: OR, odds ratio; CI, confidence interval.
Figure 3
Figure 3
Random effects meta-analysis of prospective studies of the association between anxiety and risk of hypertension (eight studies included). Note: Weights are from random effects analysis. Abbreviations: HR, hazards ratio; CI, confidence interval.
See this image and copyright information in PMC

References

    1. World Health Organization Global health risks: mortality and burden of disease attributable to selected major risks. [Accessed January, 19 2015]. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_re....
    1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–223. - PubMed
    1. Fava C, Danese E, Montagnana M, et al. Serine/threonine kinase 39 is a candidate gene for primary hypertension especially in women: results from two cohort studies in Swedes. J Hypertens. 2011;29(3):484–491. - PubMed
    1. Kowalik M. Psychosomatic aspects of arterial hypertension in women. Ann Univ Mariae Curie Sklodowska Med. 2004;59(1):245–249. - PubMed
    1. Markovitz JH, Jonas BS, Davidson K. Psychologic factors as precursors to hypertension. Curr Hypertens Rep. 2001;3(1):25–32. - PubMed