ASSOCIATION BETWEEN PSYCHOSOCIAL STRESS AND HYPERTENSION-A PROSPECTIVE STUDY

Abstract

Background
Many adults in India live with persistent work pressure, financial worries, and family responsibilitiesthat 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 datafrom Indian community and workplace cohorts remain limited, especially where individuals start outwithout diagnosed hypertension.
Objective
To examine whether higher psychosocial stress at baseline predicts the development of hypertensionover follow-up in a cohort of initially normotensive Indian adults.
Methods
This prospective study followed 300 adults, aged 25–60 years, recruited from workplaces andcommunity health camps. All participants were normotensive at baseline. Psychosocial stress wasmeasured using a validated self-report stress scale and categorisedinto 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 mmHgon follow-up, or initiation of antihypertensive medication. Relative risks were estimated for moderateand 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 anddiastolic pressures rose more steeply among participants with moderate and high stress, even afteraccounting for age and BMI. High stress at baseline was associated with a significantly greater riskof 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 wasassociated with a greater likelihood of developing hypertension over one year. Incorporating simplestress assessment into routine screening may help identify adults who would benefit from closer bloodpressure monitoring and early preventive advice.