Silent agitators: The role of anxiety in exacerbating hypertension among hospitalized patients in Subang

Main Article Content

Wiwin Sriwinengsih, S.Kep., Ners., MM
Bayu Nirwana, S.Kep., Ns., M.M

Abstract

Background: Hypertension is a leading global health concern and a major contributor to cardiovascular diseases and mortality. Anxiety, a common psychological condition, is increasingly recognized for its role in exacerbating hypertension, especially in hospitalized settings. Despite this, the relationship between anxiety and hypertension in such environments remains underexplored.


Purpose: This study investigates the relationship between anxiety levels and hypertension exacerbation among patients hospitalized in Subang, Indonesia.


Methods: A cross-sectional design was employed, involving 60 hypertensive patients admitted to a regional hospital. Anxiety levels were assessed using the Hamilton Anxiety Rating Scale (HAM-A), while blood pressure measurements were recorded during hospitalization. Logistic regression analysis was performed to determine the association between anxiety and blood pressure changes.


Results: Results indicated that higher anxiety levels were significantly associated with increased odds of hypertension exacerbation (OR 1.25; p < 0.01). The average HAM-A score was 18.7, reflecting moderate anxiety, and the mean blood pressure change was 12.5 mmHg. Demographic analysis revealed an evenly distributed sample with diverse educational and occupational backgrounds.


Conclusion: Anxiety significantly contributes to the destabilization of blood pressure in hospitalized patients, underscoring the need for integrated management strategies that address both psychological and physiological aspects of hypertension. Implementing early identification and targeted interventions for anxiety can improve hypertension outcomes and overall patient care. This study highlights the importance of a holistic approach to hypertension management, particularly in high-stress environments like hospitals.

Article Details

How to Cite
[1]
W. Sriwinengsih and B. Nirwana, “Silent agitators: The role of anxiety in exacerbating hypertension among hospitalized patients in Subang”, INJ, vol. 2, no. 2, pp. 46–50, Jan. 2025.
Section
Original Research

References

Dinas Kesehatan Subang, “Dinas Kesehatan 2022,” 2022.

World Health Organization, Noncommunicable Diseases Country Profiles 2022. Geneva: WHO, 2022.

WHO, “Hypertension Fact Sheet.” 2021. [Online]. Available: https://www.who.int

Kemenkes RI, “National report on hypertension prevalence,” Indones. Heal. Stat., vol. 5, no. 3, pp. 27–35, 2019.

S. L. James and et al., “Global, regional, and national burden of hypertension and its attributable risk factors,” Lancet, vol. 392, no. 10159, pp. 1923–1994, 2018.

T. K. Makris and et al., “The role of psychological stress in hypertension,” Curr. Hypertens. Rep., vol. 23, no. 4, p. 45, 2021.

D. J. Brotman and et al., “Anxiety and blood pressure: Mechanisms and clinical implications,” Am. J. Hypertens., vol. 35, no. 1, pp. 1–10, 2022.

S. Oparil and et al., “Impact of psychological interventions on blood pressure,” Hypertension, vol. 76, no. 5, pp. 1462–1469, 2020.

S. D. Cohen and et al., “Psychosocial factors and blood pressure control in hypertensive patients,” J. Clin. Hypertens., vol. 23, no. 7, pp. 1107–1115, 2021.

K. M. Han and et al., “Anxiety symptoms and their impact on cardiovascular health,” Gen. Hosp. Psychiatry, vol. 53, pp. 36–41, 2018.

E. Grossman and F. H. Messerli, “Hypertension and anxiety: A bidirectional relationship,” Eur. Heart J., vol. 43, no. 9, pp. 765–770, 2022.

A. V Chobanian, “The influence of stress and anxiety on hypertension: A review,” Hypertens. Res., vol. 43, no. 5, pp. 305–314, 2020.

J. A. Blumenthal and et al., “Stress management for hypertension: Evidence from randomized trials,” J. Psychosom. Res., vol. 125, pp. 109–115, 2019.

J. J. Lang and et al., “Burden of hypertension in Southeast Asia: A systematic review,” Glob. Heart, vol. 15, no. 1, pp. 31–36, 2020.

D. A. Nugraha and et al., “Integrating psychological care into hypertension management in Indonesia,” Indones. Med. J., vol. 14, no. 2, pp. 51–60, 2022.

T. Gorst and et al., “Hypertension care in low-resource settings: Innovations and challenges,” J. Glob. Health, vol. 13, p. 10204, 2023.

J. Park and et al., “The role of mindfulness and relaxation in hypertension management,” BMC Cardiovasc. Disord., vol. 21, no. 1, pp. 113–118, 2021.

M. E. Papp and et al., “Stress reduction programs for patients with hypertension: Long-term effects,” J. Hum. Hypertens., vol. 31, no. 11, pp. 712–719, 2017.

Y. Zhang and et al., “Integrating mental health in hypertension care: A review of global perspectives,” Int. J. Cardiol., vol. 310, pp. 151–157, 2020.

M. Kivimäki and et al., “Work-related stress and the risk of hypertension: A meta-analysis,” Am. J. Epidemiol., vol. 188, no. 7, pp. 1255–1265, 2019.

B. Priyanto and B. S. R. Atmojo, “The effect of progressive muscle relaxation education on the quality of sleep in elderly people with hypertension at the South Cilacap Community Health Center,” Indones. Nurs. J., vol. 1, no. 2, pp. 68–72, 2024, doi: 10.31962/inj.v1i2.173.

C. Lazzari and et al., “Anxiety disorders and hypertension: A meta-analysis,” J. Anxiety Disord., vol. 75, pp. 102–119, 2020