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Research Article: Factors associated with anxiety, depression, and cognitive impairment in individuals with hypertension: a cross-sectional study based on a Chinese population

Date Published: 2026-08-11

Abstract:
To investigate factors associated with anxiety, depressive symptoms, and cognitive impairment in individuals with hypertension. A multicenter, large-sample cross-sectional study was conducted on 1,915 essential hypertension patients from multiple hospitals in Shandong Province (May 2022–July 2024). They were divided into four groups by Mini-Mental State Examination, Hamilton Anxiety and Depression Scales: hypertension alone ( n =?1,350), with cognitive impairment ( n =?191), with anxiety/depression ( n =?309), and with all three conditions ( n =?65). Demographics, clinical indices, lifestyle, sleep quality, and treatment information were collected. Univariate analysis, binary logistic regression, and ROC curves were used to examine these factors. Independent risk factors for hypertension patients with anxiety/depression included waist circumference (OR=1.06), heart rate (1.02), education level, alcohol cessation (3.1), usual systolic blood pressure (1.02) and poor sleep; protective factors included age (0.94), height (0.96), occasional drinking (0.25), hypertension family history (0.15) and lower LDL-C (0.73). For hypertension patients with all three conditions, risk factors were waist circumference (1.07) and poor sleep. Lower LDL-C (0.62) was a protective factor. ROC curves showed good discriminative capacity (AUC=0.895, 0.887). Among individuals with hypertension, comorbid anxiety, depression, and cognitive impairment are associated with poorer sleep quality and elevated waist circumference. Lower LDL-C and appropriate lipid management may have protective effects.

Introduction:
Hypertension ranks among the most common chronic conditions worldwide, with its incidence continuing to escalate annually ( 1 ). Elevated blood pressure, according to the 2019 Global Burden of Disease Study, is the foremost attributable risk factor for mortality worldwide, accounting for 10.8 million deaths annually. It is also the principal contributor to the burden of cardiovascular disease ( 2 ). Hypertension can disrupt cerebral microcirculation, inducing structural and functional alterations in the brain that…

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