Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension

Abstract

Purpose of review: To review the most recent literature on the association between comorbid anxiety disorders and hypertension.

Recent findings: Recent longitudinal and cross-sectional studies across geographic regions and age groups predominantly demonstrate a positive association between comorbid anxiety and prevalent or incident hypertension. Growing research on blood pressure variability and reduced baroreflex sensitivity in response to autonomic dysfunction provides a greater understanding of mechanistic relationships between anxiety and hypertension. Observational studies demonstrate that young adults are at a higher risk for developing incident hypertension after an anxiety diagnosis, supporting longer exposure to alterations in autonomic mechanisms. Confounding relationships of comorbid anxiety with depression likely contribute to prior conflicting results on the association between anxiety and hypertension. There is increasing evidence of a positive association between comorbid anxiety and hypertension. This contemporaneous review supports similar findings in historical studies and provides mechanistic hypotheses for larger, longitudinal studies.

Keywords: Anxiety disorder; Autonomic nervous system; Comorbidity; Health behavior; Hypertension; Risk factors.