title: Impact of anxiety level on circadian rhythm of blood pressure in hypertensive patients.
abstract: BACKGROUND
  Considering the high prevalence rates and growing incidences of hypertension (HT) and anxiety disorders in the modern world, a full understanding of anxiety's relationship to HT is crucial. In this study we aimed to investigate the effects of anxiety level on circadian rhythm of blood pressure (BP) in hypertensive patients.
  
  
  METHODS
  This cross-sectional study included 160 previously diagnosed essential hypertensive patients (80 female, 80 male, mean age: 55.3±15.1 years). All participants underwent 24 h ambulatory blood pressure monitoring (ABPM) and filled State-Trait Anxiety Inventory (STAI) (trait) Questionnaire. The study population was divided into 2 groups according to their STAI scores; an anxiety group (n=97; STAI ≥45) and a control group (n=63; STAI<44). Clinical characteristics, laboratory findings and ABPM measurements were compared between the groups.
  
  
  RESULTS
  There was no significant difference between the groups for ABPM parameters except morning blood pressure surge (MBPS). Anxiety group had a significantly higher MBPS compared to control group (14.4±17.0 vs 9.1±11.9 mmHg, P:0.03). Multivariate analysis showed that duration of HT and STAI score were the only independent predictors of MBPS.
  
  
  CONCLUSIONS
  Patients' anxiety level is associated with MBPS which is an independent risk factor for cardiovascular complications. Assessment and control of anxiety seems to be worthy in effective treatment of hypertension.
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: Mehmet Emre
authors.initials: ME
authors.lastname: Özpelit
authors.affiliation: Department of Cardiology, School of Medicine, DokuzEylul University Izmir, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Özpelit
authors.affiliation: Department of Cardiology, Menemen State Hospital Izmir, Turkey.
authors.forename: Nazile Bilgin
authors.initials: NB
authors.lastname: Doğan
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Pekel
authors.affiliation: Department of Cardiology, Grand Medical Hospital Manisa, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ozyurtlu
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: Akar
authors.initials: A
authors.lastname: Yılmaz
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Saygı
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: İstemihan
authors.initials: İ
authors.lastname: Tengiz
authors.affiliation: Department of Cardiology, School of Medicine, Izmir University Izmir, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Ercan
keywords: Hypertension; anxiety; morning blood pressure surge