Stein DJ et al. Associations between mental disorders and subsequent onset of hypertension. Gen Hosp Psychiatry. 2014 Mar-Apr;36(2):142-9. PMID: 24342112.

Gen Hosp Psychiatry. 2014 Mar-Apr;36(2):142-9. doi: 10.1016/j.genhosppsych.2013.11.002. Epub 2013 Nov 14.

Associations between mental disorders and subsequent onset of hypertension.

Stein DJ(1), Aguilar-Gaxiola S(2), Alonso J(3), Bruffaerts R(4), de Jonge P(5), Liu Z(6), Miguel  Caldas-de-Almeida J(7), O'Neill S(8), Viana MC(9), Al-Hamzawi AO(10), Angermeyer MC(11), Benjet C(12), de Graaf R(13), Ferry F(14), Kovess-Masfety V(15), Levinson D(16), de Girolamo G(17), Florescu S(18), HuC(19), Kawakami N(20), Maria Haro J(21), Piazza M(22), Posada-Villa J(23), Wojtyniak BJ(24), Xavier M(25), Lim CC(26), Kessler RC(27), Scott KM(26).

Author information:
(1)Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address:

(2)University of California, Davis, Center for Reducing Health Disparities, School of Medicine, Sacramento, CA, USA.

(3)Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.

(4)Universitair Psychiatrisch Centrum -Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.

(5)Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.

(6)Institute of Mental Health, Peking University, Beijing, PR China.

(7)Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.

(8)Psychology Research Institute, University of Ulster, Londonderry, UK.

(9)Department of Social Medicine, Federal University of Espırito Santo (UFES), Vitoria, Brazil.

(10)Al-Qadisiya University, College of Medicine, Diwania Governorate, Iraq.

(11)Center for Public Mental Health, Gosing am Wagram, Austria.

(12)Instituto Nacional de Psiquiatria Ramon de la Fuente, Mexico City, Mexico.

(13)Department of Mental Health, School of Public Health; Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.

(14)Bamford Centre for Mental Health and Wellbeing MRC Trial Methodology Hub, University of Ulster, Londonderry, UK.

(15)Department of Epidémiologie et Biostastistiques EHESP, and Paris Descartes University Research Unit EHESP, School for Public Health Dept of Epidemiology and Biostatistics.

(16)Research & Planning, Mental Health Services Ministry of Health, Jerusalem, Israel.

(17)IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.

(18)National School of Public Health, Management and Professional Development, Bucharest, Romania.

(19)Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China.

(20)The University of Tokyo, Tokyo, Japan.

(21)Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Barcelona, Spain.

(22)Universidad Peruana Cayetano Heredia, Lima, Peru.

(23)Colegio Mayor de Cundinamarca University, Bogota, DC, Colombia.
(24)Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.

(25)Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.

(26)Department of Psychological Medicine, Otago University, Dunedin, New Zealand.

(27)Department of Health Care Policy, Harvard Medical School, Boston, MA.

BACKGROUND: Previous work has suggested significant associations between various psychological symptoms (e.g., depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remain unclear. Further, there are few data available on how such associations vary by gender or over life course.

METHODS: Data from the World Mental Health Surveys (comprising 19 countries and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated.

RESULTS: After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse and drug abuse were significantly associated with subsequent diagnosis of hypertension (with odds ratios ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier-onset hypertension.

CONCLUSIONS: Depression, anxiety, impulsive eating disorders and substance use disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.

Copyright © 2014 Elsevier Inc. All rights reserved.

PMCID: PMC3996437

PMID: 24342112 [PubMed - indexed for MEDLINE]

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