Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension
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Purpose of Review
To review the most recent literature on the association between comorbid anxiety disorders and hypertension.
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.
KeywordsHypertension Anxiety disorder Health behavior Autonomic nervous system Comorbidity Risk factors
Compliance with Ethical Standards
Conflict of Interest
The author declares no conflicts of interest relevant to this manuscript. Dr. Johnson reports grants from NIH/NHLBI, outside the submitted work.
Human and Animal Rights
All reported studies/experiments with human or animal subjects performed by the author have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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