Psychiatric comorbidities in patients with hypertension – a study of registered diagnoses 2009–2013 in the total population in Stockholm County, Sweden

OBJECTIVE:The objective of this study was to investigate the prevalence of concomitant hypertension and psychiatric disorders in the general population, using administrative healthcare data in Stockholm County. DESIGN AND METHOD:The study population, included all living persons who resided in Stockholm County 1 January 2011 (N = 2 058 408). Individuals with a diagnosis of hypertension were identified with data from all consultations in primary care, specialized outpatient care, and inpatient care 2009–2013. As outcome, data were obtained on all consultations because of certain psychiatric diagnoses between 2011 and 2013, including specifically depression, anxiety disorders, bipolar disorder, and schizophrenia. Age-adjusted odd ratios (ORs) with 95% confidence intervals (95% CI) were calculated for men and women with and without hypertension, with individuals without hypertension as referents. RESULTS:The age-adjusted ORs for depression in persons with hypertension were 1.293 (95% CI 1.256–1.331,) for men and 1.036 (95% CI 1.013–1.058) for women. The age-adjusted ORs for anxiety in persons with hypertension were 1.279 (95% CI 1.238–1.322) for men and 1.050 (95% CI 1.024–1.076) for women. The OR for bipolar disease were 0.904 (95% CI 0.826–0.990) for men and 0.709 (95% CI 0.656–0.767) for women. For schizophrenia, the ORs were 0.568 (95% CI 0.511–0.632) for men and 0.537 (95% CI 0.478–0.603) for women. CONCLUSION:Increased awareness of the risk of depression and anxiety among hypertensive patients is needed to combat hypertension, its complications, and psychiatric suffering in the population. Hypertension is probably underdiagnosed and neglected in individuals with severe psychiatric disorders. We warrant efforts to integrate psychiatric and hypertensive care.