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Hypertension, Health-Related Quality of Life and Mental Disorders: Factors associated with Awareness of Hypertension in a Community Sample

Norbert Schmitz and Johannes Kruse. Psychosomatic Medicine, Research Unit Public Mental Health, Heinrich-Heine-University, Duesseldorf, Germany, Bergische Landstr. 2 H19, D-40605 Duesseldorf, Germany, +49-221-9224723, schmitzn@uni-duesseldorf.de

Background The association between psychological characteristics and hypertension has been studied extensively, although the potential mechanisms of such an association remain speculative. Methods We analyzed data from the German National Health Interview and Examination Survey to assess the role of health status and mental disorders in the awareness of hypertension. Hypertension was defined as a blood pressure of at least 140/90 mmHg or the use of antihypertensive medication. Health status was assessed with use of the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36). Mental disorders were assessed by a modified version of the Composite International Diagnostic Interview. Results The study sample consisted of 7062 adults who were at least 18 years old and for whom blood pressure values were known. The overall prevalence of hypertension in our sample was 45.9%. Nearly half of the hypertensive subjects were aware of their elevated blood pressure status, and one third of these individuals were taking pharmacological treatment for the condition. There was no general association between hypertension and affective and anxiety disorders, but subjects with acknowledged but untreated hypertension suffered more often from affective disorders than subjects with treated hypertension. Lack of awareness of hypertension was associated with health status: With one exception subjects with acknowledged hypertension reported poorer health-related quality of life on all dimensions than subjects who were unaware of their hypertension. Conclusions Our findings suggest that affective and anxiety disorders are not directly associated with hypertension. Associations between mental disorders, health status, and hypertension should be evaluated with respect to awareness and treatment of hypertension.

Learning Objectives:

Keywords: Epidemiology, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Mental Health and Medical Comorbidity

The 132nd Annual Meeting (November 6-10, 2004) of APHA