Evaluation of the relationship between hypertension and anxiety and depression

Objective: Hypertension is one of the most common cardiovascular diseases worldwide, contributing significantly to mortality and morbidity. Anxiety and depression, whether occurring alone or as comorbidities with chronic illnesses, are frequently encountered psychiatric disorders that negatively affect disease prognosis, treatment adherence, and quality of life. In this study, we aimed to investigate the prevalence and severity of anxiety and depression accompanying essential hypertension, as well as the relationship of these psychological symptoms with various variables. Materials and Methods: This cross-sectional study was conducted between February and June 2025 in the district of Turhal, at the Şht. Pyd. Uzm. Çvş. Emrah Çeçen Aile Sağlığı Merkezi, involving 161 patient participants aged 18-65 who had been diagnosed with primary hypertension and were using at least one antihypertensive medication, and 160 control participants without a history of hypertension. All procedures were explained to both the patient and control groups, and informed consent forms were obtained. Individuals with conditions that could cause secondary hypertension, such as thyroid disorders, parathyroid disorders, adrenal disorders, or pituitary disorders, as well as those with infectious diseases, dementia, alcohol or substance use, comorbid conditions such as mental retardation, illiteracy, or those under 18 or over 65 years of age, were excluded from the study. All participants were administered a socio-demographic data form (Appendix 1), prepared by the researchers through a literature review, which included variables such as age, gender, education level, marital status, occupation and presence of chronic disease. In addition, the Beck Depression Inventory (Appendix 2) and the Beck Anxiety Inventory (Appendix 3) were applied. The data obtained from the study were analyzed using IBM SPSS version 25.0. Results: As a result of our study, anxiety and depression scores were found to be higher in the patient group compared to the control group. When supra-threshold psychiatric findings were evaluated, anxiety was found to be significant in patients with hypertension (p<0.05), whereas no significant difference was observed in terms of depression (p>0.05). In analyses conducted by gender and occupation, both Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores were significantly higher among women and housewives (p<0.001 for both). An inverse relationship was identified between education level and BDI scores; depression scores decreased significantly as the level of education increased (p=0.031). Additionally, both BAI and BDI scores were lower among participants who engaged in regular exercise (p<0.01). In contrast, no significant associations were observed between scale scores and marital status, income level, medication adherence, salt restriction or number of antihypertensive drugs used (p>0.05). Conclusion: The frequent occurrence of anxiety and depressive symptoms in hypertensive patients highlights the importance of conducting mental health screenings. In particular, the fact that anxiety yields significant results above threshold levels supports the existence of shared pathophysiological pathways between hypertension and anxiety. Therefore, addressing anxiety symptoms may help reduce medication burden, improve treatment adherence, and lower overall treatment costs.