Study sheds new light on relationship of anxiety and high blood pressure to primary aldosteronism

A study that has been published in the Journal of Clinical Endocrinology and Metabolism by an Italian group headed by Nicoletta Sonino (Padova) sheds some new light on the relationship of anxiety and high blood pressure to a hormonal disturbance, primary aldosteronism.

The objective of this study was to investigate psychological correlates in a population with primary aldosteronism (PA) using methods found to be sensitive and reliable in psychosomatic research. Twenty-three PA patients (12 male, 11 female; mean age 50 ± 9 yr) were compared with 23 patients with essential hypertension (EH) (15 male, eight female; mean age 47± 8 yr) and 23 matched normotensive subjects.

A modified version of the Structural Clinical Interview for DSM-IV, a shortened version of the structured interview for the Diagnostic Criteria for Psychosomatic Research, and two self-rating questionnaires, the Psychosocial Index and the Symptom Questionnaire, were administered. Twelve of 23 patients with PA (52.2%) suffered from an anxiety disorder compared with four of 23 with EH (17.4%) and one control (4.3%) (P <0.001). Generalized anxiety disorder was more frequent in PA than in EH patients and controls (P<0.05). As assessed by Diagnostic Criteria for Psychosomatic Research, irritable mood was more frequent in PA and EH compared with controls (P<0.05 ) but did not differentiate PA from EH. According to psychosocial Index results, patients with PA had higher levels of stress (P<0.01) and psychological distress (P<0.01) and lower level of well-being (P<0.05) than controls. Compared with EH patients, PA patients had higher scores in stress subscale (P<0.05).

The Symptom Questionnaire showed higher levels of anxiety (P<0.01), depression (P<0.01) and somatization (P< 0.01) and lower physical well-being (P< 0.05) in PA than controls. A role of mineralocorticoid regulatory mechanisms in clinical situations concerned with anxiety and stress is suggested.