Effect of salt adherence and blood pressure control on anxiety, depression, and quality of life in essential hypertension

Introduction and Aim: Essential hypertension is a significant public health concern worldwide, associated not only with cardiovascular complications but also closely linked to patients' quality of life, anxiety, and depression levels. This study aimed to investigate the relationship among salt consumption, quality of life, and psychological status (anxiety, depression) in patients diagnosed with essential hypertension. Material and Method: The study was conducted between August 2024 and November 2024 in the Internal Medicine and Nephrology outpatient clinics of Manisa Celal Bayar University Hafsa Sultan Hospital. A total of 120 patients, who had been diagnosed with essential hypertension for at least 6 months, participated in the study. To evaluate compliance with salt restriction, participants were asked to undergo a 24-hour urinary sodium excretion measurement. Quality of life was measured using the 36-Item Short Form Survey (SF-36), while anxiety and depression levels were assessed with the Hospital Anxiety and Depression Scale (HADS). Statistical analyses of the data were performed using SPSS 15.0, with a significance level set at p<0.05. Results: The mean age of the participants was 57.93±13.27 (range 28–88) years, with 55% being female and 45% male. Regarding occupational status, the highest rate was observed among retirees (34.2%). In terms of educational level, half of the participants were primary school graduates, while 10% were illiterate. Based on 24-hour urinary sodium excretion, kidney function tests (urea, creatinine, GFR) were generally within normal limits. The HADS results showed mean anxiety and depression scores of 8.25±4.60, respectively. SF-36 general health scores were at a moderate level, and there was a statistically significant negative correlation between SF-36 and HADS (p<0.05). Patients whose blood pressure was not fully controlled had higher depressive symptoms, although this difference did not reach statistical significance (p>0.05). No significant difference in blood pressure control was observed between those who adhered to salt restriction and those who did not (p>0.05). Although no significant difference was found in anxiety levels, depression levels were found to be higher among patients with uncontrolled blood pressure who adhered to salt restriction (p=0.732; p=0.030). Conclusion: In patients diagnosed with essential hypertension, significant relationships were observed among salt consumption habits, quality of life, and psychological well-being. In particular, the finding that depression and anxiety levels correlate negatively with quality of life underscores the importance of psychosocial support in this patient group. Long-term and more comprehensive follow-ups on salt restriction compliance may contribute to a clearer understanding of the relationship between hypertension management and mental health. Keywords: Anxiety, Depression, Essential hypertension, Salt intake, Quality of life