Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Nov 19, 2026; 16(11): 122420
Published online Nov 19, 2026. doi: 10.5498/wjp.122420
Published online Nov 19, 2026. doi: 10.5498/wjp.122420
Potential impact of generalized anxiety disorder on future hypertension risk: Investigating the role of psychophysiological stress pathways
Le-Rong Ouyang, Qiu-Hong Li, Licheng Community Health Service Center, Headquarters of Shenzhen Nanshan Medical Group, Shenzhen 518055, Guangdong Province, China
Le-Rong Ouyang, General Outpatient Clinic, Southern Medical University Shenzhen Hospital, Shenzhen 518101, Guangdong Province, China
Miao-Ling Zheng, Xi Yang, Department of Traditional Chinese Medicine, Nanshan Community Health Service Center, Headquarters of Shenzhen Nanshan Medical Group, Shenzhen 518055, Guangdong Province, China
Jin-Yi Hu, Department of Public Health, School of Public Health, Southern Medical University, Shenzhen 510515, Guangdong Province, China
Hu Xie, Department of Social Health Management, Headquarters of Shenzhen Nanshan Medical Group, Shenzhen 518052, Guangdong Province, China
Jian-Bin Xue, Department of Disease Prevention, Guangzhou Baiyun District Center for Disease Control and Prevention, Guangzhou 510440, Guangdong Province, China
Xin-Yue Lin, Cotton Ridge Community Health Service Center, Shenzhen Luohu Hospital Group, Shenzhen 518019, Guangdong Province, China
Co-first authors: Le-Rong Ouyang and Miao-Ling Zheng.
Author contributions: Ouyang LR and Zheng ML contributed equally to this work as co-first authors; Ouyang LR, Zheng ML, and Lin XY conceived and designed the study; Ouyang LR, Zheng ML, Li QH, Xie H, Yang X, Xue JB, and Lin XY were responsible for data acquisition; Ouyang LR, Zheng ML, Hu JY, and Xue JB performed the data analysis and interpretation; Ouyang LR and Zheng ML drafted the manuscript; Hu JY, Li QH, Xie H, Yang X, Xue JB, and Lin XY critically revised the manuscript for important intellectual content; Lin XY supervised the study and is the guarantor of this work. All authors have read and approved the final manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Institutional review board statement: This study was reviewed by the Ethics Committee of the Medical Committee of Southern Medical University Shenzhen Hospital, No. NYSZYYEC2022K112R009.
Clinical trial registration statement: We would like to respectfully clarify that the present study was a prospective observational cohort study and did not involve prospective assignment of participants to any intervention. This study was approved by the institutional ethics committee before enrollment, and written informed consent was obtained from all participants.
Informed consent statement: All study participants or their legal guardians provided written informed consent before study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Xin-Yue Lin, MD, Cotton Ridge Community Health Service Center, Shenzhen Luohu Hospital Group, No. 2 Xinmian Road, Shenzhen 518019, Guangdong Province, China. 13410786720@163.com
Received: May 19, 2026
Revised: July 6, 2026
Accepted: July 31, 2026
Published online: November 19, 2026
Processing time: 162 Days and 15.9 Hours
Revised: July 6, 2026
Accepted: July 31, 2026
Published online: November 19, 2026
Processing time: 162 Days and 15.9 Hours
Core Tip
Core Tip: This prospective observational cohort study suggests that generalized anxiety disorder (GAD) is associated with future hypertension risk in a clinic-based population without baseline hypertension. Among the 300 participants, the 12-month incidence of sustained new-onset hypertension was higher in the GAD group (37.5% vs 6.9%). This association persisted after expanded adjustment for clinical variables, psychotropic/hypnotic medication use, physical activity, and dietary salt intake (adjusted odds ratio = 2.31). Patients with GAD also showed higher cortisol, C-reactive protein, and interleukin-6 levels and impaired heart rate variability. Exploratory mediation analysis supported cortisol and heart rate variability as possible statistical links; however, causal interpretation requires longer-term studies with repeated biomarker measurements.