Identification of Mental Health Disorder Symptoms, Predisposing Factors and their Impact on Quality of Life in Young Hypertensive Patients: A Multicenter Longitudinal Study

Abstract

Introduction Mental health problems in young adults with hypertension are often underrecognized, despite their potential impact on quality of life and long-term outcomes. Evidence in younger populations remains limited, particularly in longitudinal and multicenter settings. Objective To examine the relationship between hypertension duration, mental health symptoms, and quality of life among young adults, as well as to explore psychosocial stressors identified through qualitative inquiry. Methods This multicenter longitudinal study recruited patients aged 18–45 years with hypertension from outpatient clinics across several Indonesian cities. Participants were assessed at baseline using the Depression Anxiety Stress Scale-21 (DASS-21) and the WHO Quality of Life-BREF (WHOQOL-BREF). Hypertension duration was recorded as a continuous variable. A subset of participants underwent semi-structured interviews to explore psychosocial stressors. Quantitative data were analyzed using correlation analysis, while qualitative data were analyzed thematically. Results A total of 791 participants were included in the study, with a mean age of 33 ± 10.14 years, and women slightly outnumbered men. This study found that a longer duration of hypertension was associated with worse overall quality of life (r = -0.45) and lower psychological well-being (r = -0.40). Notable correlations also emerged between hypertension duration and higher levels of anxiety (r = -0.42), depression (r = -0.38), and stress (r = -0.30), while socioeconomic and psychosocial stressors emerged as major contributing factors. Discussion This multicenter longitudinal study suggests a direct link between early-adulthood hypertension and subsequent psychological distress, particularly anxiety and depressive symptoms, as well as lower quality of life with aging. Recent findings underscore that hypertension in young individuals extends beyond cardiovascular risk and may also impose a substantial mental health burden. Evidence identifying socioeconomic and psychosocial stressors as key predisposing factors further strengthens the rationale for incorporating routine mental health screening and psychosocial interventions into standard hypertension management protocols, thereby enhancing patients’ quality of life and potentially improving long-term clinical outcomes. Conclusion In this multicenter longitudinal cohort, a longer duration of hypertension was associated with greater psychological distress and poorer quality of life among young adults. These findings support the integration of routine mental health screening into hypertension care.