ArticleAnatolian journal of cardiology2024
A Metric Shedding Light on the Relationship Between White Coat Hypertension and Anxiety: The Hospital Anxiety and Depression Scale-Anxiety.
Article in Anatolian journal of cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Autonomic cardiovascular mechanisms linked to stress in dental practice.British dental journal · 2026Review
- Reply to Letter to the Editor: "HADS-A in White Coat Hypertension: Limitations and Future Directions".Anatolian journal of cardiology · 2025Article
- HADS-A in White Coat Hypertension: Limitations and Future Directions.Anatolian journal of cardiology · 2025Article
- Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients.Sports (Basel, Switzerland) · 2025Article
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Authors and funding
9 authors.
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Abstract
backgroundTo investigate the relationship between anxiety and white coat hypertension (WCH) using the hospital anxiety and depression scale-anxiety (HADS-A) score.
methodsParticipants lacking a pre-existing diagnosis of hypertension but displaying increased office blood pressure were included in this study. Subsequently, they were classified as either newly diagnosed sustained hypertension (SustHT) or white coat hypertension (WCH) patients, as determined by 24-hour ambulatory blood pressure monitoring measurements. The assessment of their anxiety levels was conducted using the HADS-A questionnaire. We performed regression, comparative, and sensitivity analyses to elucidate the association between anxiety and WCH.
resultsIn this cohort of 303 consecutive individuals (mean age 54 years, 46% female), 81 (26.7%) patients were diagnosed with WCH. Those with WCH were younger (49 vs. 56 years, P < .001), had higher heart rate (85 vs. 76 bpm, P < .001) and exhibited a female predominance (56% vs. 43%, P = .049) compared to individuals with SustHT. The HADS-A was higher in WCH than in SustHT (9.0 ± 2.9 vs. 6.6 ± 2.6, P < .001). Furthermore, HADS-A showed positive correlation with systolic and diastolic pressures measured in the out-patient clinic (r = 0.523 and r = 0.387, respectively; P < .001 for both). The full model with HADS-A had better discriminatory power (Harrell's c-index 0.82 vs. 0.77, P = .0025), increased calibration, and a greater net benefit than the base model without. The ROC curve analysis, using a cut-off of >6 for HADS-A, demonstrated a sensitivity of 76.5% and specificity of 53.6% in detecting WCH (Area Under the Curve = 0.72, P < .001).
conclusionsOur study revealed that individuals with WCH, in comparison to those with SustHT, exhibit a higher level of anxiety as indicated by HADS-A.
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