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http://dx.doi.org/10.24986/anxmod.2022.18.1.003

Psychosocial Factors Influencing Anxiety Symptoms in Patients With Hypertension  

Moon, Seock Hyeon (Department of Psychiatry, Chosun University Hospital)
Kim, Seung-Gon (Department of Psychiatry, Chosun University Hospital)
Yang, Hae-Jung (Department of Psychiatry, Chosun University Hospital)
Seo, Eun Hyun (Premedical Science, Chosun University College of Medicine)
Yoon, Hyung-Jun (Department of Psychiatry, Chosun University Hospital)
Publication Information
Anxiety and mood / v.18, no.1, 2022 , pp. 17-25 More about this Journal
Abstract
Objective : The aim of this study was to investigate the prevalence of anxiety symptoms and its association with psychological factors in patients with hypertension. Methods : The Participants included 124 patients with hypertension. Anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale. Socio-demographics, perceived stress, state-trait anger, life satisfaction, and ego resiliency were assessed. Stepwise multiple regression analyses were carried out to examine the impact of perceived stress, state-trait anger, and life satisfaction on anxiety symptoms. In addition, moderated regression analysis was performed to explore the moderating effect of ego resiliency between perceived stress and anxiety symptoms. Results : A total of 17 subjects (13.7%) were identified as having anxiety symptoms. Higher perceived stress and state-trait anger, and lower life satisfaction were found to be significant correlates of anxiety symptoms. In the final model, higher levels of perceived stress (β=0.378, p<0.001) and trait anger (β=0.320, p<0.001) were related to higher levels of anxiety symptoms, while a higher level of life satisfaction (β=-0.166, p=0.025) was associated with a lower level of anxiety symptoms. Further, ego resiliency buffered the negative effect of perceived stress on anxiety symptoms. Conclusion : This study demonstrated the prevalence of anxiety symptoms and associated psychological factors among patients with hypertension. Our findings suggest that improving life satisfaction and ego-resiliency as well as controlling stress and anger may be important in the management of anxiety symptoms in patients with hypertension.
Keywords
Hypertension; Anxiety; Stress; Anger; Life satisfaction; Ego resiliency;
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1 Hamrah MS, Hamrah MH, Ishii H, Suzuki S, Hamrah MH, Hamrah AE, et al. Anxiety and depression among hypertensive outpatients in Afghanistan: a cross-sectional study in Andkhoy City. Int J Hypertens 2018;2018:8560835.   DOI
2 Pan Y, Cai W, Cheng Q, Dong W, An T, Yan J. Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies. Neuropsychiatr Dis Treat 2015;11:1121-1130.   DOI
3 Bomhof-Roordink H, Seldenrijk A, van Hout HP, van Marwijk HW, Diamant M, Penninx BW. Associations between life stress and subclinical cardiovascular disease are partly mediated by depressive and anxiety symptoms. J Psychosom Res 2015;78:332-339.   DOI
4 Farber F, Rosendahl J. The association between resilience and mental health in the somatically ill. Dtsch Arztebl Int 2018;115:621-627.
5 Baker R, Holloway J, Thomas PW, Thomas S, Owens M. Emotional processing and panic. Behav Res Ther 2004;42:1271-1287.   DOI
6 Strine TW, Chapman DP, Balluz LS, Moriarty DG, Mokdad AH. The associations between life satisfaction and health-related quality of life, chronic illness, and health behaviors among US community-dwelling adults. J Community Health 2008;33:40-50.   DOI
7 Suls J, Wan CK, Costa PT Jr. Relationship of trait anger to resting blood pressure: a meta-analysis. Health Psychol 1995;14:444-456.   DOI
8 Williams JE, Nieto FJ, Sanford CP, Couper DJ, Tyroler HA. The association between trait anger and incident stroke risk: the Atherosclerosis Risk in Communities (ARIC) Study. Stroke 2002;33:13-19.   DOI
9 Schwerdtfeger A, Gaisbachgrabner K, Traunmuller C. Life satisfaction and hemodynamic reactivity to mental stress. Ann Behav Med 2017;51:464-469.   DOI
10 Rosella LC, Fu L, Buajitti E, Goel V. Death and chronic disease risk associated with poor life satisfaction: a population-based cohort study. Am J Epidemiol 2019;188:323-331.   DOI
11 Kulkarni S, O'Farrell I, Erasi M, Kochar MS. Stress and hypertension. WMJ 1998;97:34-38.
12 Kubo T, Sugawara D, Masuyama A. The effect of ego-resiliency and COVID-19-related stress on mental health among the Japanese population. Pers Individ Dif 2021;175:110702.   DOI
13 Statistics Korea. Causes of death statistics in 2020. Available at http://kostat.go.kr/assist/synap/preview/skin/miri.html?fn=eeab063920849408160437&rs=/assist/synap/preview. Accessed on October 11, 2021
14 Kretchy IA, Owusu-Daaku FT, Danquah SA. Mental health in hypertension: assessing symptoms of anxiety, depression and stress on antihypertensive medication adherence. Int J Ment Health Syst 2014;8:25.   DOI
15 Bautista LE, Vera-Cala LM, Colombo C, Smith P. Symptoms of depression and anxiety and adherence to antihypertensive medication. Am J Hypertens 2012;25:505-511.   DOI
16 Paterniti S, Alperovitch A, Ducimetiere P, Dealberto MJ, Lepine JP, Bisserbe JC. Anxiety but not depression is associated with elevated blood pressure in a community group of French elderly. Psychosom Med 1999;61:77-83.   DOI
17 Mittal BV, Singh AK. Hypertension in the developing world: challenges and opportunities. Am J Kidney Dis 2010;55:590-598.   DOI
18 Wei TM, Wang L. Anxiety symptoms in patients with hypertension: a community-based study. Int J Psychiatry Med 2006;36:315-322.   DOI
19 Spielberger CD. Preliminary Manual for the State-Trait Anger Scale (STAS). Tampa: University of South Florida Human Resources Institute;1980.
20 Cohen BE, Edmondson D, Kronish IM. State of the art review: depression, stress, anxiety, and cardiovascular disease. Am J Hypertens 2015;28:1295-1302.   DOI
21 Seo EH, Kim SG, Kim SH, Kim JH, Park JH, Yoon HJ. Life satisfaction and happiness associated with depressive symptoms among university students: a cross-sectional study in Korea. Ann Gen Psychiatry 2018;17:52.   DOI
22 Philippe FL, Laventure S, Beaulieu-Pelletier G, Lecours S, Lekes N. Ego-resiliency as a mediator between childhood trauma and psychological symptoms. J Soc Clin Psychol 2011;30:583-598.   DOI
23 Oh SM, Min KJ, Park DB. A study on the standardization of the Hospital Anxiety and Depression Scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc 1999;38:289-296.
24 Aberha M, Gebeyehu A, Ayano G. Prevalence and factors associated with anxiety among patients with hypertension on follow up at Menelik-II Referral Hospital, Addis Ababa Ethiopia. J Psychiatry 2016;19:1000378.
25 Grimsrud A, Stein DJ, Seedat S, Williams D, Myer L. The association between hypertension and depression and anxiety disorders: results from a nationally-representative sample of South African adults. PLoS One 2009;4:e5552.   DOI
26 Liu MY, Li N, Li WA, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurol Res 2017;39:573-580.   DOI
27 Carroll D, Phillips AC, Gale CR, Batty GD. Generalized anxiety and major depressive disorders, their comorbidity and hypertension in middle-aged men. Psychosom Med 2010;72:16-19.   DOI
28 Wiegner L, Hange D, Bjorkelund C, Ahlborg G Jr. Prevalence of perceived stress and associations to symptoms of exhaustion, depression and anxiety in a working age population seeking primary care--an observational study. BMC Fam Pract 2015;16:38.   DOI
29 Schum JL, Jorgensen RS, Verhaeghen P, Sauro M Thibodeau R. Trait anger, anger expression, and ambulatory blood pressure: a meta-analytic review. J Behav Med 2003;26:395-415.   DOI
30 de Bles NJ, Rius Ottenheim N, van Hemert AM, Putz LEH, van der Does AJW, Penninx BWJH, et al. Trait anger and anger attacks in relation to depressive and anxiety disorders. J Affect Disord 2019;259:259-265.   DOI
31 Mei S, Qin Z, Yang Y, Gao T, Ren H, Hu Y, et al. Influence of life satisfaction on quality of life: mediating roles of depression and anxiety among cardiovascular disease patients. Clin Nurs Res 2021;30:215-224.   DOI
32 Milioni M, Alessandri G, Eisenberg N, Castellani V, Zuffiano A, Vecchione M, et al. Reciprocal relations between emotional self-efficacy beliefs and ego-resiliency across time. J Pers 2015;83:552-563.   DOI
33 Jung HW, Kim SH, Park SH, Kim SG, Kim JH, Seo EH, et al. Association of depressive/anxiety symptoms with ego resilience and social conflict/support in patients with diabetes mellitus. Anx Mood 2020;16:9-17.   DOI
34 Liu X, Yang X, Yao L, Zhang Q, Sun D, Zhu X, et al. Prevalence and related factors of depressive symptoms in hemodialysis patients in northern China. BMC Psychiatry 2017;17:128.   DOI
35 Block JH, Block J. The role of ego-control and ego-resiliency in the organization of behavior. In: Collins WA, editors. Development of cognition, affect, and social relations. Mahwah: Lawrence Erlbaum Associates;1980. p.39-101.
36 Klohnen EC. Conceptual analysis and measurement of the construct of ego-resiliency. J Pers Soc Psychol 1996;70:1067-1079.   DOI
37 Baek YM. Korean version of the perceived stress scale-10: development of the scale and exploring the effects of perceived stress on memory [dissertation]. Seoul: Seoul National Univ.;2010.
38 Chon KK, Hahn DW, Lee CH. Korean adaptation of the state-trait anger expression inventory (STAXI-K): the case of college students. Korean J Health Psychol 1998;3:18-32.
39 Kim EH, Park HS. The impacts of organizational job stress factors on organizational commitment: focusing on the effects of ego-resilience. Korean Gov Rev 2010;17:1-28.
40 Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol 2005;60:410-421.   DOI
41 Lee EK. The effects of neuroticism and extraversion on subjective well-being: the importance of depression and positive emotions [dissertation]. Seoul: Yonsei Univ.;2005.