title: The comorbidity of hypertension and psychological distress: a study of nine countries in the former Soviet Union.
abstract: BACKGROUND
  Mental health problems in those with physical ailments are often overlooked, especially in the former Soviet Union (fSU) where this comorbidity has received little attention. Our study examines the comorbidity of psychological distress and hypertension in the fSU.
  
  
  METHODS
  Nationally representative household survey data from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2001 and 2010 were analysed to compare the levels of psychological distress in people with and without self-reported hypertension. Multivariate regression analysed determinants of psychological distress in hypertensive respondents, and prevalence rate ratios were calculated to compare the change in distress between the two groups.
  
  
  RESULTS
  There were significantly higher levels of psychological distress among hypertensive respondents (9.9%) than in the general population (4.9%), and a significant association between the two conditions [odds ratio (OR) = 2.27 (1.91; 2.70)]. Characteristics associated with distress among hypertensive respondents included residing in Armenia or Kyrgyzstan, being female, over age 50, with a poor economic situation, lower education, poor emotional support and limited access to medical drugs. Levels of distress declined between 2001 and 2010, but at a lesser rate in hypertensive respondents [rate ratio (RR) = 0.85 (0.75; 0.95)] than non-hypertensive respondents [RR = 0.65 (0.56; 0.75)].
  
  
  CONCLUSIONS
  There is a significant association between psychological distress and hypertension in the region.
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
authors.forename: Katharine
authors.initials: K
authors.lastname: Footman
authors.forename: Bayard
authors.initials: B
authors.lastname: Roberts
authors.forename: Sergei
authors.initials: S
authors.lastname: Tumanov
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001136:Armenia / Q000453:epidemiology; D001382:Azerbaijan / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007623:Kazakhstan / Q000453:epidemiology; D007707:Kyrgyzstan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008966:Moldova / Q000453:epidemiology; D015995:Prevalence; D002094:Republic of Belarus / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D014455:Ukraine / Q000453:epidemiology; D055815:Young Adult
keywords: chronic disease; mental health; morbidity and mortality