A Prospective Study on Anxiety and Blood Pressure Levels in Hemodialysis Patients During COVID-19 Pandemic

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has currently been one of the leading causes of psychosocial stress throughout the world. We hypothesized that possible changes in anxiety status during the COVID-19 pandemic might affect blood pressure in hemodialysis (HD) patients. Methods: This is an observational cross-sectional study. The Hospital Anxiety and Depression Scale (HADS) and State-Trait Anxiety Inventory (STAI) were applied to 71 prevalent HD patients. Pre-dialysis blood pressure was measured, and the systolic blood pressure measurements of 6 consecutive HD sessions were averaged. All assessments were performed both at the beginning (March) and after the end (June) of the partial lockdown, which was officially instituted by the Government in Turkey. Results: The mean age (+/- SD) was 59.2 +/- 14.8 years and 52% of the patients were female. The STAI-State score was higher in March than in June (44.6 +/- 12.6 vs. 42.3 +/- 11.5, respectively, P =.047), whereas the HADS-Anxiety, HADS-Depression, and STAI-Trait scores were not different. The pre-dialysis systolic blood pressure was significantly higher in March than in June (127.9 +/- 20.3 vs. 124.8 +/- 22.8 mmHg, respectively, P =.029). The change in state anxiety score from March to June was remarkable, particularly in patients not taking a beta-blocker (49.3 +/- 9.6 to 43.8 +/- 11.1, P =.001) and in patients younger than the median age of 64 years (48.6 +/- 12.8 to 45.3 +/- 12.5, P =.029). The change in blood pressure level from March to June was found to be significant only in patients not taking a beta-blocker (123.4 +/- 20.2 to 118.2 +/- 20.6 mmHg, P <.001), while it did not reach a statistically significant level in the others. Conclusion: Our findings revealed an association between a higher state of anxiety and a higher blood pressure level in HD patients during the COVID-19 pandemic, which was remarkable particularly in patients not taking a beta-blocker.