Potential impact of generalized anxiety disorder on future hypertension risk: Investigating the role of psychophysiological stress pathways

Table 6 Mediating pathway and effect of generalized anxiety disorder and new-onset hypertension

Mediating pathway	Indirect effects (ab)	Bootstrap 95%CI	P value	Mediated proportion (%)
Pathway 1: GAD → cortisol ↑ → new-onset hypertension	0.106	0.028-0.214	0.008	18.0
Pathway 2: GAD → HRV composite score ↓ → new-onset hypertension	0.085	0.017-0.187	0.014	14.5
Pathway 3a: GAD → CRP ↑ → new-onset hypertension	0.035	-0.002 to 0.090	0.066	6.0
Pathway 3b: GAD → IL-6 ↑ → new-onset hypertension	0.041	0.001-0.10	0.045	7.0
Pathway 4 (chain): GAD → cortisol ↑ → HRV ↓ → new-onset hypertension	0.024	-0.001 to 0.066	0.058	4.0
Cortisol ↑ + HRV ↓ combined mediation				32.5

Heart rate variability in the mediation model refers to the prespecified standardized heart rate variability composite score; individual heart rate variability indices were not entered simultaneously to avoid multicollinearity. HRV: Heart rate variability; GAD: Generalized anxiety disorder; CI: Confidence interval; CRP: C-reactive protein; IL-6: Interleukin-6.