ASSOCIATION BETWEEN PSYCHOSOCIAL STRESS AND HYPERTENSION- A PROSPECTIVE STUDY

Abstract

Background

Many adults in India live with persistent work pressure, financial worries, and family responsibilities that rarely receive clinical attention, yet these stresses can quietly shape cardiovascular risk. Psychosocial stress has been linked to higher blood pressure in several settings, but prospective data from Indian community and workplace cohorts remain limited, especially where individuals start out without diagnosed hypertension.

Objective

To examine whether higher psychosocial stress at baseline predicts the development of hypertension over follow-up in a cohort of initially normotensive Indian adults.

Methods

This prospective study followed 300 adults, aged 25–60 years, recruited from workplaces and community health camps. All participants were normotensive at baseline. Psychosocial stress was measured using a validated self-report stress scale and categorised into low, moderate, and high stress. Blood pressure was recorded at baseline and at 12-month follow-up using standard procedures. Incident hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg on follow-up, or initiation of antihypertensive medication. Relative risks were estimated for moderate and high stress compared with low stress, with subgroup analyses across age, sex, and BMI.

Results

Over 12 months, 54 participants (18.0%) developed hypertension. Incidence was lowest in the low-stress group and almost doubled in those with high psychosocial stress at baseline. Mean systolic and diastolic pressures rose more steeply among participants with moderate and high stress, even after accounting for age and BMI. High stress at baseline was associated with a significantly greater risk of incident hypertension, and this pattern was particularly evident in adults aged 40 years and above.

Conclusion

In this cohort of initially normotensive Indian adults, higher psychosocial stress at baseline was associated with a greater likelihood of developing hypertension over one year. Incorporating simple stress assessment into routine screening may help identify adults who would benefit from closer blood pressure monitoring and early preventive advice.