Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies

• Published in: Journal of nephrology Vol. 37; no. 3; pp. 647 - 660
• Main Authors: Schuchman, Matthew, Brady, Tammy M., Glenn, Dorey A., Tuttle, Katherine R., Cara-Fuentes, Gabriel, Levy, Rebecca V., Gonzalez-Vicente, Agustin, Alakwaa, Fadhl M., Srivastava, Tarak, Sethna, Christine B.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-04-2024
• Subjects: Adolescent; Adult; Anxiety - epidemiology; Blood Pressure; Child; Depression - epidemiology; Female; Humans; Hypertension - epidemiology; Hypertension - psychology; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Mental Health; Middle Aged; Nephrology; Original Article; Patient Reported Outcome Measures; Proteinuria - epidemiology; Stress, Psychological - epidemiology; Urology; Young Adult; Blood pressure; PROMIS; Glomerular disease; Mental health
• ISSN: 1724-6059; 1724-6059
• DOI: 10.1007/s40620-024-01919-6

Introduction
The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies.
Methods
An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes.
Results
In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes.
Discussion/conclusion
Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.
Graphical abstract