Gender- and Age-Specific Associations of Visit-To-Visit Blood Pressure Variability with Incident Generalized Anxiety Disorder

BackgroundThere is a bidirectional relationship between blood pressure variability (BPV) and generalized anxiety disorder (GAD), but few studies have examined the gender- and age-specific effects of visit-to-visit BPV on GAD incidence. We examined the predictive value of BPV for the incidence of GAD in a family clinic cohort.MethodsConsecutive patients with a first attendance to family medicine clinics in Hong Kong between January 1st, 2000, and December 31st, 2002, with at least three blood pressure measurements available thereafter were included. The primary endpoint was incident GAD as identified by ICD-9 coding from the local Clinical Data Analysis and Reporting System.ResultsThis study included 48023 (50% males) patients with a median follow-up of 224 (IQR: 217-229) months. Females were more likely to develop GAD compared to males (incidence rate: 7% vs. 2%), as were patients of older age. Significant univariate predictors were female gender, older age, pre-existing cardiovascular diseases, respiratory diseases, diabetes mellitus, hypertension, and gastrointestinal diseases, various laboratory examinations and the number of blood pressure measurements. Higher baseline, maximum, minimum, SD, CV, and variability score of diastolic blood pressure significantly predicted GAD, as did all systolic blood pressure measures (baseline, latest, maximum, minimum, mean, median, variance, SD, RMS, CV, variability score).ConclusionsThe relationships between longer term visit-to-visit BPV and incident GAD were identified. Female and older patients with higher blood pressure and higher BPV were at the highest risks of GAD.