Abstract
Patients with hypertension (HTN) are at increased risk of developing cardiovascular disease, which can be reduced with blood pressure (BP) control. Anxiety can contribute to high BP and low heart rate variability (HRV). Although relationships between social support, self-rated health-status (SRHS), anxiety and measures of HRV and BP have been suggested, they have not been clearly established. This cross-sectional correlational study aimed to 1) examine relationships between social support, SRHS, and anxiety; and 2) examine if HRV mediated relationships between anxiety symptoms and BP. Patients with primary HTN were recruited from a cardiovascular outpatient clinic using convenience sampling (N = 300). Data included scale scores for SRHS, social support, and anxiety (Hospital Anxiety and Depression Scale). A handheld limb-lead electrocardiogram monitor measured HRV, using the ratio of low-frequency bands to high-frequency bands; an automatic sphygmomanometer measured systolic and diastolic blood pressure (SBP and DBP, respectively). Path analysis of structural equation models examined relationships between variables; the bootstrap method examined the mediating effects of HRV. Analysis showed scores for SRHS and social support had a direct effect on anxiety scores. Scores for anxiety directly affected HRV and BP. HRV also had a direct effect on BP. Bootstrapping indicated HRV mediated the relationship between anxiety symptoms and BP. The final model indicated SRHS, social support, and anxiety symptoms together explained 80% of SBP and 33% of DBP. These findings suggest HRV could be used to measure the effectiveness of strategies aimed at reducing anxiety and improving control of BP.
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Data Availability
No datasets were generated or analysed during the current study.
Abbreviations
- BP :
-
Blood pressure
- DBP and SBP :
-
Diastolic and systolic blood pressure, respectively; heart rate variability
- HRV :
-
Self-reported health status
- SRHS:
-
Hospital Anxiety and Depression Scale-Anxiety
- HADS-A :
-
Structural equation modeling, SEM
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The authors would like to express their sincere gratitude to all the participants who provided valuable information and time in this study.
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TYC and CWK designed the study and evaluated the data. TYC drafted and revised the manuscript. SMC recruited the participants. CYL conducted the statistical analysis. All authors provided advice regarding revisions to the manuscript. All authors have read and approved the final manuscript.
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Chen, TY., Kao, CW., Cheng, SM. et al. Mediating Effect of Heart Rate Variability on the Relationship Between Anxiety Symptoms and Blood Pressure in Patients with Primary Hypertension. Appl Psychophysiol Biofeedback (2024). https://doi.org/10.1007/s10484-024-09641-6
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DOI: https://doi.org/10.1007/s10484-024-09641-6