- Researchers investigated the effects of high blood pressure on depressive symptoms and well-being.
- They found that high blood pressure is linked to reduced depressive symptoms and higher well-being but that a hypertension diagnosis is linked to the inverse.
- Further research is needed to confirm the findings.
Hypertension and depression frequently occur together, and both are risk factors for cardiovascular disease.
Studies have also shown that hypertension may cause depressive symptoms in aging through microvascular brain damage. Research also shows that an increased heart rate induces anxious behavior in mice.
However, other studies show that high blood pressure is linked to better mood, higher well-being, and lower distress.
Better understanding of the link between hypertension and depressive symptoms could improve the management of both conditions.
Recently, researchers investigated the link between hypertension and depressive symptoms using medical data from a cohort of over 500,000.
They found that higher systolic blood pressure is linked to fewer depressive symptoms, but that a hypertension diagnosis and an impending diagnosis are linked to poorer mental health.
“This link between cardiovascular functioning and mental health may lead to interventions for treatments for behavioral conditions through adjustments to the cardiovascular system and vice versa,” noted Dr. Michael J. McGrath, board-certified psychiatrist, medical director of The Ohana Luxury Alcohol Rehab, who was not involved in the study, speaking to Medical News Today.
“[These findings] will open up a whole new avenue as to how we should approach HTN and mental health prevention and treatment.”
— Dr. Sarika Shanmukayya, a primary care physician with Memorial Hermann in Houston, Texas, who was not involved in the study, speaking to MNT.
The study was published in Nature Communications.
Hypertension linked to more depressive symptoms
For the study, the researchers included healthcare data from 502,494 individuals in the UK Biobank database. At the beginning of the study, individuals included in the analysis were an average of 58 years old.
Healthcare data included:
- hypertension diagnosis
- blood pressure readings
- number of antihypertensive medications
- survey on frequency of depressive symptoms in the last two weeks
- 7-point questionnaire on well-being
- MRI scans
Researchers took participants’ blood pressure readings twice, an average of nine years apart, and recorded their mental health and well-being measures at baseline, five and 10 years later. The participants underwent MRI scans at the 10-year follow-up.
In the end, the researchers found that higher systolic blood pressure was linked to fewer depressive symptoms and greater well-being at all assessments.
Systolic blood pressure measures the pressure in your arteries each time the heart beats while diastolic blood pressure is the pressure in arteries when it rests between beats.
They found, however, that a hypertension diagnosis and an impending diagnosis were linked to more depressive symptoms and lower well-being.
The findings remained after controlling for medications, chronic illness, and social factors.
Why higher blood pressure is linked to less depression
MNT asked Dr. McGrath what might explain the link between higher systolic blood pressure and fewer depressive symptoms.
“This study proposed that the elevated systolic pressure signals a positive rewarding experience by triggering pressure-sensitive nerve receptors called baroreceptors. This was proposed as a mechanism for decreasing physical and social pain and leading to improved mental health,” he said.
Dr. Alex Dimitriu, double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, who was not involved in the study, agreed that the study reports that people with elevated blood pressure have a reduced emotional experience.
“These findings support that having higher blood pressure may make individuals more tolerant to both physical and psychic pain, resulting in improved distress tolerance, which may improve depression ratings,“ he noted.
Long-term increases may be harmful
Dr. Howard Pratt, D.O., psychiatrist and board-certified medical director at Community Health of South Florida, Inc. (CHI), who was also not involved in the study, noted that while short-term increases in blood pressure might be beneficial, long-term increases can be harmful.
“We may be able to perform well during stressful situations over the short term, but increased cortisol and other factors while operating under stress over the long term can result in chronic hypertension, the so-called silent killer, that has been linked to many adverse health effects that make one’s overall health significantly worse. Meanwhile, depression is medical and often goes unrealized until it affects someone personally,” he said.
The difference between short and long-term elevations in blood pressure may explain why higher blood pressure may be beneficial, yet a hypertension diagnosis and impending diagnosis non-beneficial.
Limitations
MNT also spoke with Dr. Shannon Hoos-Thompson, a cardiologist at The University of Kansas Health System, who was not involved in the study, about its limitations.
“While the findings are interesting there is no proof here, just educated guesses. The study does not show a connection between the two conditions. Findings were mined data with no controls,” she said.
“I would say nothing further about the study other than it is a curious thought with no proof. This ‘study’ does not meet scientific standards for reliable results and therefore no conclusions may be made,” she added.
Dr. Pratt, meanwhile, noted:
“Blood pressure is only one metric of overall health. But blood pressure does not occur in a vacuum. While the study looked at over 500,000 people over several years, these are all individuals with unique habits and lifestyles and while they self-reported their hypertension, we don’t know how compliant each of them was about taking their medications if they were medicated for hypertension.”
“Also, the study took the first blood pressure reading and averaged the second blood pressure reading and this may lead to an underestimation of the prevalence of hypertension,” he added.
Keeping blood pressure in check
“This study is far from conclusive, but could promote further research in this area to try to identify and isolate additional variables that could strengthen the findings,” said Dr. Gregory Nawalanic, clinical assistant professor of psychiatry and behavioral sciences at The University of Kansas Health System.
“That is the beauty of research—every answer serves to generate more questions that can lead us to more answers. In this way, as our knowledge base grows, clinical care is enhanced,” he noted.
“While these findings may not be directly applicable to how we currently treat hypertension and clinical outcomes, they do shed light on the correlation between mental health and blood pressure. We now know that mental health is correlated in blood pressure increasing during the aging process, which could open possibilities for new preventative approaches.”
— Dr. Karishma Patwa, a cardiologist at Manhattan Cardiology, cardiologist, who was also not involved in the study, speaking to MNT
“This is a fascinating study, and speaks to the balance between pain tolerance and mood symptoms. It is interesting to see that living with high blood pressure results in some level of ‘toughness,’ which is protective from depression,” Dr. Dmitriu added.
He cautioned, however: “[There is possibly a] ‘slippery slope’ of people accepting that hypertension may confer mood benefits while overlooking the overall negative health risks of the condition — including risk of negative cardiovascular outcomes.”
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