Generalized anxiety disorder and the circadian rhythm of blood pressure in patients with hypertension

Objective. To investigate the impact of generalized anxiety disorder (GAD) on the circadian rhythm of blood pressure in patients with hypertension. Methods. The 24-h ambulatory blood pressure was compared between patients with hypertension and GAD, and patients with hypertension only. Results. The mean day- and night-time systolic (SBP, 156.611.0 and 149.612.4 mmHg, respectively) blood pressure in patients with GAD was greater than in the no-GAD group (143.215.0 and 126.010.8 mmHg, respectively, P0.01). The mean day- and night-time diastolic blood pressure (DBP, 101.510.1 and 96.917.6 mmHg, respectively) in the GAD group was also greater than in the no-GAD group (94.110.9 and 77.410.2 mmHg, respectively, P0.01). SBP and DBP dipping was found in 87.5 and 80.1% of the hypertension only patients, as compared with 16.6 and 21.4% respectively, of the hypertension and GAD patients (P0.01). Conclusions. The presence of GAD is associated with a higher level of blood pressure in hypertensive patients. GAD is also associated with a diminished circadian rhythm of blood pressure. The clinical significance of the reduced blood pressure dipping at night requires further investigation.