Factors associated with anxiety, depression, and cognitive impairment in individuals with hypertension: a cross-sectional study based on a Chinese population.

OBJECTIVE: To investigate factors associated with anxiety, depressive symptoms, and cognitive impairment in individuals with hypertension. METHODS: A multicenter, large-sample cross-sectional study was conducted on 1,915 essential hypertension patients from multiple hospitals in Shandong Province (May 2022-July 2024). They were divided into four groups by Mini-Mental State Examination, Hamilton Anxiety and Depression Scales: hypertension alone (n = 1,350), with cognitive impairment (n = 191), with anxiety/depression (n = 309), and with all three conditions (n = 65). Demographics, clinical indices, lifestyle, sleep quality, and treatment information were collected. Univariate analysis, binary logistic regression, and ROC curves were used to examine these factors. RESULTS: Independent risk factors for hypertension patients with anxiety/depression included waist circumference (OR=1.06), heart rate (1.02), education level, alcohol cessation (3.1), usual systolic blood pressure (1.02) and poor sleep; protective factors included age (0.94), height (0.96), occasional drinking (0.25), hypertension family history (0.15) and lower LDL-C (0.73). For hypertension patients with all three conditions, risk factors were waist circumference (1.07) and poor sleep. Lower LDL-C (0.62) was a protective factor. ROC curves showed good discriminative capacity (AUC=0.895, 0.887). CONCLUSION: Among individuals with hypertension, comorbid anxiety, depression, and cognitive impairment are associated with poorer sleep quality and elevated waist circumference. Lower LDL-C and appropriate lipid management may have protective effects.