Psychological Distress and the Development of Hypertension Over 5 Years in Black South Africans

Alarming increases in the incidence of hypertension in many low‐ and middle‐income countries are related to alcohol overuse. It is unclear whether alcohol overuse is a symptom of psychological distress. The authors assessed psychological distress in Africans and its relationship with a 5‐year change in blood pressure ( BP ), independent of alcohol intake. The authors followed 107 Africans with optimal BP (≤120/80 mm Hg) (aged 35–75 years) over 5 years. Alcohol intake (self‐report and serum γ‐glutamyl transferase) and nonspecific psychological distress (Kessler Screening Scale for Psychological Distress [K6]) were assessed. The K6 predicted hypertension development ( P =.019), and its individual component “nervous” increased a participant's risk two‐fold to become hypertensive (hazard ratio, 2.00 [1.23–3.26]). By entering K6 and γ‐glutamyl transferase into multivariable‐adjusted regression models for change in systolic BP , both were independently associated with change in systolic BP . Psychological distress and scoring high on being nervous predicted the development of hypertension over 5 years, independent of alcohol intake.