ASSOCIATIONS BETWEEN PSYCHOLOGICAL STRESS AND BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS

Abstract

Background: Hypertension is a leading cause of cardiovascular morbidity worldwide, and its management extends beyond pharmacological interventions. Psychological stress has emerged as a critical factor influencing blood pressure control, often exacerbating the condition. Recent studies suggest that lifestyle factors, including physical inactivity and poor sleep, contribute to stress-induced hypertension. However, limited research has focused on this association in regional populations. This study evaluated the impact of psychological stress on blood pressure among hypertensive patients.

Objective: The study aimed to examine the association between psychological stress and blood pressure control in hypertensive patients, and to identify modifiable risk factors related to chronic disease, physical inactivity, work environment, home stress, and sleep quality.

Methods: A descriptive cross-sectional study was conducted on 284 hypertensive male patients from three community healthcare clinics in Punjab between April and June 2024. Systematic random sampling was employed to select a representative cohort. Data were gathered using a self-administered questionnaire based on the validated Depression, Anxiety, and Stress Scale (DASS-42), and responses were collected via Google Forms. Statistical analyses were performed using SPSS version 27, where descriptive statistics summarized participant characteristics and inferential analyses explored associations between psychological stress and various clinical factors, including chronic disease presence, exercise levels, and stressors in both work and home environments as well as sleep quality.

Results: Of the 284 participants, 157 (55.3%) reported elevated psychological stress, with a mean DASS-42 stress score of 16.5 ± 7.8. Chronic disease was reported in 34% of the sample, inadequate exercise in 67%, a stressful work environment in 38%, a stressful home environment in 30%, and insufficient sleep in 40% of patients. Notably, participants experiencing a stressful work environment were 4.10 times more likely to exhibit high stress (95% CI: 2.05–8.24; p < 0.001). These findings provided compelling numerical evidence that psychological stress and several modifiable factors were strongly associated with suboptimal blood pressure control.

Conclusion: The study concluded that psychological stress significantly affected blood pressure control among hypertensive patients. Modifiable factors such as chronic disease, lack of exercise, work and home stress, and poor sleep quality contributed to elevated stress levels. These findings underscored the need for integrated stress management interventions alongside traditional hypertension treatment to enhance overall patient outcomes and reduce cardiovascular risk.