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July 12, 2026PLoS ONEOpen Access

Depression and anxiety linked to lower self-care levels in hypertensive patients.

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Why the study?

Are depression, anxiety, and stress associated with lower self-care levels in patients with hypertension?

Population

509 hypertensive patients in Gonabad, Iran. Inclusion criteria: confirmed diagnosis of hypertension by a…

Design

Cross-sectional

Key result

Depression and anxiety were significantly negatively correlated with self-care levels in hypertensive patients (r = -0.314 and r = -0.330, respectively; p < 0.001).

Authors

FNFatemehzahra NaddafiAJAlireza JafariMNMahbobeh Nejatian

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Overview

High psychological distress was associated with poorer self-care; leaves open whether screening or treating distress improves hypertension outcomes.

Key Points

  • The study aims to investigate the prevalence of psychological factors like anxiety, depression, and stress and their relationship with self-care behaviors in hypertensive patients.
  • Conducted an analytical cross-sectional study in Gonabad, Iran, in 2024–2025 with 509 hypertensive patients.
  • Used cluster random sampling and self-administered questionnaires, including DASS-21 and SC-HI V3.
  • Analyzed data using SPSS v25, employing tests such as independent t-tests, ANOVA, and Pearson’s correlation.
  • 62.5% of patients exhibited depression, 75.2% anxiety, and 59.3% stress.
  • Significant negative correlation found between depression (r = −0.314, p < 0.001) and anxiety (r = −0.330, p < 0.001) with self-care levels.
  • Variables like depression, anxiety, stress, age, education, and income predict 15% of the variance in hypertension self-care.

Study Design

Type

Cross-Sectional (n=509)

Structured PICO

Are depression, anxiety, and stress associated with lower self-care levels in patients with hypertension?

P
Population
509 hypertensive patients without cognitive impairment, residing in Gonabad for at least one year, assessed for the impact of psychological distress on self-care.
O
Outcome
Prevalence of anxiety, depression, and stress and their association with self-care levels (measured by DASS-21 and SC-HI V3)patient reported

Main Result

Effect estimate: r = -0.314 (depression), r = -0.330 (anxiety)

p-value: p=<0.001

Cite This Study

Naddafi et al. (2026) conducted a cross-sectional in Hypertension (n=509). Psychological distress (depression, anxiety, stress) was evaluated on Self-care levels (SC-HI V3) (r = -0.314 (depression), r = -0.330 (anxiety), p=<0.001). Depression and anxiety were significantly negatively correlated with self-care levels in hypertensive patients (r = -0.314 and r = -0.330, respectively; p < 0.001).

synapsesocial.com/papers/6a5334194f7abc118adee2echttps://doi.org/10.1371/journal.pone.0352892
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Unmasking the Mental Health Burden of Hypertension: Examining Psychological Distress, And Cognitive Function, Impact on Quality of Life in Patients Undergoing Treatment in a Tertiary Care Hospital2025 · 4 citations
  2. 2Depression, Anxiety, Stress, and Their Association with Hypertension Treatment Adherence in the Elderly2025
  3. 3Cognitive function, emotion regulation and social-support in self-care among individuals with hypertension2025
  4. 4Understanding the Psychological Factors that Impact Hypertension: A Systematic Review2025
  5. 5Health-related quality of life among adults with hypertension with or without anxiety and depression: estimates from a national US data2025