Association Between Anxiety and Hypertension in Working-Age Adults: A Cross-Sectional Study

Abstract

Background: Anxiety is a prevalent psychological condition that activates neuroendocrine stress pathways and may contribute to blood pressure dysregulation. Hypertension remains a major global public health concern and is frequently undiagnosed among working-age adults, who are commonly exposed to substantial psychosocial stressors.
Objective: To examine the association between anxiety levels and hypertension among working-age adults in Kartasura District, Sukoharjo Regency, Indonesia.
Methods: This community-based cross-sectional study included 219 adults aged 22–59 years, recruited using consecutive non-random sampling. Anxiety levels were assessed using the Zung Self-Rating Anxiety Scale, while blood pressure was measured with a calibrated digital sphygmomanometer. Hypertension was categorized according to national clinical guidelines. Data were analyzed using Kendall’s tau-b correlation test with a significance level of 0.05.
Results: Most participants reported mild to moderate anxiety, and more than 40% were classified as hypertensive. A statistically significant and strong positive correlation was observed between anxiety level and hypertension severity (r = 0.626; 95% CI 0.55–0.70; p < 0.001), indicating that higher anxiety scores were consistently associated with higher blood pressure categories.
Conclusion: Anxiety levels are strongly associated with hypertension among working-age adults. These findings highlight the importance of integrating psychological assessment and stress management into hypertension prevention and control strategies, particularly within primary care and physiotherapy-based services.