Associations between mental disorders and subsequent onset of hypertension

Dan J. Stein, Sergio Aguilar-Gaxiola, Jordi Alonso, Ronny Bruffaerts, Peter De Jonge, Zharoui Liu, Jose Miguel Caldas-de-Almeida, Siobhan O'Neill, Maria Carmen Viana, Ali Obaid Al-Hamzawi, Mattias C. Angermeyer, Corina Benjet, Ron De Graaf, Finola Ferry, Viviane Kovess-Masfety, Daphna Levinson, Giovanni De Girolamo, Silvia Florescu, Chiyi Hu, Norito KawakamiJosep Maria Haro, Marina Piazza, Jose Posada-Villa, Bogdan J. Wojtyniak, Miguel Xavier, Carmen C.W. Lim, Ronald C. Kessler, Kate M. Scott

Research output: Contribution to journalArticlepeer-review

107 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)142-149
Number of pages8
JournalGeneral Hospital Psychiatry
Issue number2
Publication statusPublished - Mar 2014


  • Common mental disorders
  • Hypertension
  • World mental health surveys


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