Correlation Between Undiagnosed Depression, Anxiety Disorder, and

Hypertension in Cililin Primary Health Center: An Analytical Study

Achmad Fitrah Khalid1, Margono Gatot Suwandi2
1
General Practitioner in Air Force Central Hospital Dr. S. Hardjolukito, Yogyakarta
2
Cardiologist in Air Force Central Hospital Dr. S. Hardjolukito, Yogyakarta

Background: Depression, anxiety disorder, and hypertension have been hypothesized and studied for
their association. Psychosocial stressor, depression, and anxiety disorder could raise autonomic arousal
via the hypothalamic-pituitary axis which increase catecholamine. This phenomenon could increase the
risk of hypertension.1 if this condition left untreated, it could make the hypertension harder to control.
Objective: To find the correlation between depression, anxiety disorder, and hypertension.
Method: Data was taken from patients in PROLANIS activity at Cililin Primary Health Center from
November 2017 – January 2018. Patient’s blood pressure was measured by standard
sphygmomanometer following AHA recommendation. Zung Self-Rating Depression Scale and Zung
Self-Rating Anxiety Scale were used to diagnose and determine the severity of depression and anxiety
disorder. Association between depression, anxiety, and hypertension were determined using the
spearman correlation test.
Result: Seventy-five patient were found in this study, which 39 (52%) of them were female. Adult
patient was higher (n=47) than elderly. The average age of those patients were 58  9.338 years old.
Data showed that 50 patients (66.7%) already had hypertension more than 5 years. Data also showed
that 28 patients (37.3%) had poor control of their hypertension. Mild Depression was found in 36
patients (48%) in this study, while moderate depression was found in 16 patients (21.3%). 1 patient
(1.3%) has been found with severe depression. Mild to moderate anxiety disorder was found in 49
patients (65.3%), while severe anxiety disorder was found in 6 patients (8%). There was a moderate
positive correlation between depression score (rs = .326, p = 0.004) and anxiety score (rs = .338, p =
.003) with hypertension.
Conclusion: Moderate positive association between depression, anxiety, and hypertension have been
found in this study. However, many other factors can contribute to hypertension or affective disorder.
Screening for depression and anxiety disorder in hypertension patients is recommended to improve the
outcome of the treatment.

Keywords: Depression, Anxiety Disorder, Long-standing Hypertension