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Articles: Nisha I. Parikh, Michael J. Pencina, Thomas J. Wang, Emelia J. Benjamin, Katherine J. Lanier, Daniel Levy, Ralph B. D'Agostino, Sr, William B. Kannel, and Ramachandran S. Vasan A Risk Score for Predicting Near-Term Incidence of Hypertension: The Framingham Heart Study Ann Intern Med 2008; 148: 102-110 [Abstract] [Full text] [PDF]

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Francisco Sánchez   (31 March 2008)

Relation between anxiety and the hypertension risk

Liu Hong, Kaichun Wu and Daimng Fan   (24 January 2008)

Untitled 31 March 2008
Francisco Sánchez, MD Ediciones Mayo Send rapid response to journal: Re: this article fsanchez{at}edicionesmayo.es Francisco Sánchez	Dear Dr. Nisha, I was very impressed by a risk factor calculator for predicting hypertension. Could this calculator be used in the clinical follow-up of the pre-hypertense patient? I supposse there is an option for on-line calculation, althoung I haven´t seen any link in the paper. Thank-you very much and congratulations for this valuable item. Francisco Sánchez Barcelona Spain Conflict of Interest: None declared
Relation between anxiety and the hypertension risk 24 January 2008
Liu Hong, PhD Institute of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, China, Kaichun Wu and Daimng Fan Send rapid response to journal: Re: Relation between anxiety and the hypertension risk hlhyhj{at}126.com Liu Hong, et al.	Parikh NI et al do develop a simple risk prediction algorithm that estimates an individual's 1-, 2- and 4-year probability of developing hypertension. They examine the following candidate risk factors: age, sex, body weight, body mass index, physical activity index, systolic blood pressure, diastolic blood pressure, moderate alcohol intake, parental hypertension and cigarette smoking [1]. And their risk score does not take into account some predictors of hypertension that may not be routinely measured, such as nonsteroidal anti-inflammatory drugs, salt intake, vegetable, fat intake, or exercise. However, one important clinical predictor of hypertension, anxiety, is not involved in their investigation. Anxiety is known to be closely associated with incident hypertension, and may be the precursor to hypertension [2,3]. The higher rate of hypertension incidence is found closely accompanied with anxiety for Chinese patients [4]. In general, the more nervous Chinese hospital patients fell, the higher blood pressure they get. Anxiety can easily be measured in a physician's office in primary care settings. For example, at each Framingham Heart Study examination, the investigators may record and evaluate the following factors of anxiety: the daily intensity (with a score range from 0 to 5; 0 being the minimum; 5 being the maximum level), duration (hours per month), and frequency (days per month). Parikh NI and colleagues do not provide any information regarding the relation of anxiety with the hypertension risk. The readers will be very interested to know whether anxiety is one significant predictor of hypertension for nonhypertensive white individuals. Reference: 1 Parikh NI, Pencina MJ, Wang TJ, Benjamin EJ, Lanier KJ, Levy D, et al. A risk score for predicting near-term incidence of hypertension: the Framingham Heart Study. Ann Intern Med. 2008; 148(2): 102-10. 2 Spruill TM, Pickering TG, Schwartz JE, Mostofsky E, Ogedegbe G, Clemow L, et al. The impact of perceived hypertension status on anxiety and the white coat effect. Ann Behav Med. 2007; 34(1): 1-9. 3 Dimsdale JE. Symptoms of anxiety and depression as precursors to hypertension. JAMA. 1997; 277(7): 574-5. 4 Wei TM, Wang L. Anxiety symptoms in patients with hypertension: a community-based study. Int J Psychiatry Med. 2006; 36(3): 315-22. Conflict of Interest: None declared