School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK.
Centre for Innovation in Mental Health, School of Psychology, University of Southampton, UK; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.
Neurosci Biobehav Rev. 2021 Dec;131:96-119. doi: 10.1016/j.neubiorev.2021.08.031. Epub 2021 Sep 2.
We assessed the association between anxiety and hypertension in adults via a systematic review/meta-analysis. We searched PubMed, Ovid, and PsycINFO through 27 March 2020 with no language or publication type restrictions and systematically contacted study authors for unpublished information/data. We meta-analysed 59 studies including a total of 4,012,775 participants. Study quality was rated with the Newcastle-Ottawa Scale and random-effects analyses were performed. A significant anxiety-hypertension association was found in cross-sectional (OR = 1.37, 95 % CI = 1.21-1.54) and prospective studies (OR = 1.40, 95 % CI = 1.23-1.59). In sensitivity analyses, results were influenced by method of hypertension diagnosis, but not by study quality, method of anxiety diagnosis, study population, and effect size type. In subgroup analyses, study location, in particular country economic status, but not participant age, influenced the results. Longitudinal data and theoretical literature indicate that anxiety may precede hypertension. These findings have important clinical implications for the early detection and treatment of both anxiety and hypertension. Suggestions for future research are discussed.
我们通过系统评价/荟萃分析评估了成年人焦虑与高血压之间的关系。我们于 2020 年 3 月 27 日以前，在 PubMed、Ovid 和 PsycINFO 上进行了无语言或出版类型限制的搜索，并系统地联系研究作者以获取未发表的信息/数据。我们荟萃分析了 59 项研究，共纳入了 4012775 名参与者。研究质量采用纽卡斯尔-渥太华量表进行评估，并进行了随机效应分析。横断面研究（OR=1.37，95%CI=1.21-1.54）和前瞻性研究（OR=1.40，95%CI=1.23-1.59）均显示出焦虑与高血压之间存在显著关联。敏感性分析结果表明，研究结果受到高血压诊断方法的影响，但不受研究质量、焦虑诊断方法、研究人群和效应量类型的影响。亚组分析表明，研究地点，特别是国家经济状况，而非参与者年龄，会影响结果。纵向数据和理论文献表明，焦虑可能先于高血压发生。这些发现对焦虑和高血压的早期发现和治疗具有重要的临床意义。我们还讨论了未来研究的建议。
