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Association between perceived stress and hypertension in Chinese adults: a population-based survey

Journal of Human Hypertension volume 37, pages 321–326 (2023)Cite this article

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Abstract

It still remains unclear whether perceived stress is associated with hypertension. We aimed to investigate the association between perceived stress with hypertension in Chinese adults. Data on 10,823 participants aged 18 years or older were obtained from the 2015 China Health and Nutrition Survey (CHNS). Hypertension was defined as a mean systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, self-reported physician diagnosis of hypertension, and/or use of antihypertensive medications. Perceived stress was assessed by the 14-item perceived stress scale, with the scale data then divided into quartiles. Logistic regression models and restricted cubic spline regression were performed to evaluate the association between perceived stress and hypertension. After adjustment for age, gender, marital status, education level, per capita household income, employment status, residential areas, current smoking and alcohol consumption, the odds ratio (OR) [95% confidence interval (CI)] for every standard deviation (SD) increment in perceived stress was 0.94 (0.90–0.98); compared to the lowest quartile of perceived stress (Q1), the ORs (95% CIs) for hypertension were 0.88 (0.78–1.01) for Q2, 0.91 (0.81–1.03) for Q3, and 0.82 (0.72–0.92) for Q4 (P for trend < 0.001). The inverse association between perceived stress and hypertension was persistent in the subgroup analyses stratified by age, gender, employment status, residential areas, smoking status, and alcohol consumption. In addition, the restricted cubic spline curve revealed a linear and negative association between perceived stress and hypertension (P for nonlinearity = 0.872). Because this study was a cross-sectional design, future prospective studies are needed to confirm these findings.

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Fig. 1: Dose–response relationship between perceived stress and hypertension.

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Data availability

The current research uses data from the China Health and Nutrition Survey (CHNS). Data are available in a public, open access repository at https://www.cpc.unc.edu/projects/china (accessed on 10 August 2021).

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Acknowledgements

This research uses data from the China Health and Nutrition Survey (CHNS). We thank the National Institute of Nutrition and Food Safety (China Center for Disease Control and Prevention), Carolina Population Center (University of North Carolina at Chapel Hill) for providing analysis files.

Funding

This work was supported by the National Natural Science Foundation of China (71974101).

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Authors and Affiliations

  1. Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China

    Dianjiang Li

  2. Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China

    Dianjiang Li

  3. Research Center for Social Risk Governance for Major Public Health Events, Nanjing Medical University, Nanjing, China

    Dianjiang Li

  4. Department of Health Service and Management, School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China

    Chao Rong

  5. Department of Health Policy Research, Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China

    Qi Kang

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Contributions

DJL contributed to the conception, analysis, and interpretation of data, drafted the report, and received the final version for publication.CR and QK performed data clean, and revised the manuscript. All authors read the article and approve it for publication.

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Correspondence to Dianjiang Li.

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Li, D., Rong, C. & Kang, Q. Association between perceived stress and hypertension in Chinese adults: a population-based survey. J Hum Hypertens 37, 321–326 (2023). https://doi.org/10.1038/s41371-022-00684-y

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