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Brain & Heart

REVIEW ARTICLE
Depression and anxiety levels in patients with

hypertension and relationship with blood
pressure control: A review of study design for

psychiatric intervention protocol

Georgia Balta 1 , Dimitris Konstantinidis 1 , Dimitris Dikeos 2 ,
1
Kostas Gatzoulis 1 , Costas Tsioufis 1 , and Dimitris Tsiachris *
1 First Department of Cardiology, Hippokration General Hospital, Medical School, National and
Kapodistrian University of Athens, Athens, Greece
2 First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian
University of Athens, Athens, Greece

Abstract

Arterial hypertension, anxiety, and depression are common in Western and Eastern
medicines, with each offering therapeutic instructions and proposals. Arterial
hypertension has been identified as a harmful factor that causing cardiovascular
diseases and increasing global mortality. Depression affects over 322 million people
*Corresponding author: worldwide, with an overall incidence of 4.4%. In cases of hypertension, depression
Dimitris Tsiachris is observed in approximately 30% of patients when assessed using questionnaires
(dtsiachr@med.uoa.gr) and in approximately 21% when assessed psychiatrically. Anxiety and depression
Citation: Balta G, Konstantinidis D, are risk factors for arterial hypertension. On the contrary, hypertension has been
Dikeos D, Gatzoulis K, Tsioufis C, considered to cause anxiety and depressive symptoms. This could be attributed to
Tsiachris D. Depression and anxiety the direct effects of high blood pressure (BP), side effects of antihypertensive drugs,
levels in patients with hypertension
and relationship with blood pressure or psychological reactions to the diagnosis of hypertension. An unhealthy lifestyle
control: A review of study design increases stress and BP levels. Therefore, controlling stress is a complementary therapy
for psychiatric intervention protocol. for hypertension. In this context, this study presents a protocol aimed at evaluating
Brain & Heart. 2025;3(1):4923.
doi: 10.36922/bh.4923 stress/depression levels as well as the quality of life in patients with hypertension and
examining their correlation with BP control and target organ damage. In addition, we
Submitted: September 24, 2024
will assess the effect of subsequent psychiatric interventions in hypertensive patients
Revised: November 18, 2024 with increased levels of depression/stress on BP control, treatment compliance, and
Accepted: November 18, 2024 quality of life after a follow-up period of 1 year.
Published online: December 17,
2024 Keywords: Hypertension; Depression; Anxiety; Treatment; Psychiatry
Copyright: © 2024 Author(s).
This is an Open Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, 1. Introduction to psychocardiology
and reproduction in any medium,
provided the original work is In the present era, the brain is widely recognized as the organ responsible for thoughts
properly cited. and sentiments. The encephalon, weighing approximately 1.400 g, regulates behavior
Publisher’s Note: AccScience and emotions, whereas the heart, a renowned muscular pump, supplies oxygen to all
Publishing remains neutral with cells. However, a strong connection exists between these two major human organs.
regard to jurisdictional claims in 1
published maps and institutional In 1985, Jefferson first introduced the term psychocardiology, establishing a strong
affiliations. bidirectional relationship. Indeed, the nervous and cardiovascular systems constantly

Volume 3 Issue 1 (2025) 1 doi: 10.36922/bh.4923