Cognitive function, emotion regulation and social-support in self-care among individuals with hypertension

Akanksha Arora; Sonia Puar; Deepika Srivastav; Santosh Kumar Agarwal

doi:10.18203/2394-6040.ijcmph20252471

Authors

Akanksha Arora Amity Institute of Behavioural Health and Allied Science, Amity University, Noida Campus, Uttar Pradesh, India
Sonia Puar Amity Institute of Behavioural Health and Allied Science, Amity University, Noida Campus, Uttar Pradesh, India
Deepika Srivastav Amity Institute of Behavioural Health and Allied Science, Amity University, Noida Campus, Uttar Pradesh, India
Santosh Kumar Agarwal Kailash Hospital and Heart Institute, Noida, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20252471

Keywords:

Cognitive function, Emotion regulation, Social-support, Self-care, Hypertension

Abstract

Background: Hypertension, a crucial chronic disease risk factor in India, has been highlighted in recent epidemiological studies to be surging in rural and young populations. The incidence of adverse events by cause of hypertension related cardiovascular health illness is on peak. Hypertension is recognized as the most consistent risk factor for cognitive decline, associated with reduced executive functioning, slowed processing speed and deficits in memory. Additionally, the socio emotional factors like emotion regulation and social support play a significant role in symptom exacerbation, poor self-care and treatment outcomes. Improving upon the cognitive and socio emotional domains becomes imperative to ensure better self-management and life outcomes. Aim of the study was to explore the role of cognitive function, emotion regulation and social support in self-care among individuals with hypertension.

Methods: In this cross-sectional study, 31 adults aged 30-60 years diagnosed with hypertension, were approached through purposive sampling. The individuals were assessed using psychological measures: PGI memory scale (PGI-MS), trail making test A and B (TMT), emotion regulation questionnaire (ERQ), Duke-UNC functional social support questionnaire (DUFSS), self-care inventory (SCI).

Results: Participants were adults aged 30-60 years, with a higher proportion of males. Cognitive variables-particularly memory, attention, and executive functioning-were positively associated with self-care - maintenance, monitoring, and management. FSS showed strong positive relationships with cognitive functioning, emotional regulation, and all domains of self-care. In contrast, expressive suppression was negatively related to self-care maintenance.

Conclusions: The study explored the role of cognitive functioning and socio-emotional factors in individuals with hypertension implying whether improving these factors can lead to better self-care and management.

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References

World Health Organization. Hypertension. 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed on 21 June 2025.

Rathore SS, Krumholz HM, Wang Y. Depression, anxiety, and the risk of cardiovascular events in patients with hypertension. JAMA Internal Med. 2014;174(XX):1046-52.

Kojima K, Sato T, Fukuda K. Anxiety and depression in patients with hypertension: A systematic review and meta-analysis. Hypert Res. 2014;37(XX):975-80.

Maddox L, Wang Y, Jansson C. The psychological impact of chronic hypertension. J Clin Psychol. 2016;72(XX):963-70.

Thompson WR, Frost DM, Reed AA. Anxiety and depression in individuals with hypertension: A meta-analysis. Hypert Res. 2019;42(XX):1063-71.

Carey RM, Wright JT Jr, Taler SJ, Whelton PK. Guideline-driven management of hypertension: An evidence-based update. Circulation Res. 2021;128(7):827-46. DOI: https://doi.org/10.1161/CIRCRESAHA.121.318083

Gorman BK, McCollum ED, Staudinger LA. The psychological burden of hypertension: A review of the literature. J Behavioral Med. 2020;43(XX):118-31.

Jin Y, Zhang W, Liu M. The association between hypertension and cognitive decline: A review of the literature. J Alzheimer’s Dis. 2020;74(XX):431-41.

Liu S, Xu Y, Zhao F. Social isolation and its psychological effects in hypertensive patients. Int J Social Psychiat. 2018;64(XX):232-9.

Prasad K. PGI Memory Scale. Postgraduate Institute of Medical Education and Research. 1977.

Reitan RM. The Trail Making Test: Manual for administration and scoring. Reitan Neuropsychological Laboratory. Indianapolis, IN: Indiana University Press. 1958.

Gross JJ, John OP. Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. J Per Soc Psychol. 2003;85(2):348-62. DOI: https://doi.org/10.1037/0022-3514.85.2.348

Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH. The Duke-UNC Functional Social Support Questionnaire: Measurement of social support in family medicine patients. Med Care. 1988;26(7):709-23. DOI: https://doi.org/10.1097/00005650-198807000-00006

Luciani M, Alvarado M, González R. The Self-Care Inventory: Development and validation of a new measure of self-care for individuals with chronic illness. Int J Nursing Studies. 2011;48(XX):1164-72.

Jin Y, Zhang W, Liu M. The association between hypertension and cognitive decline: A review of the literature. J Alzheimer’s Dis. 2020;74(XX):431-41.

Fisher L, Chin MH, Lurie P. Improving self-management in patients with chronic conditions: A comprehensive model. J Chronic Dis Management. 2021;22(XX):215-25.

Williams P, Johnson A. The role of self-care monitoring and social support in managing hypertension. J Hypert Care. 2020;33(XX):57-64.

Krittanawong C, Zhang H, Wang Z. Cognitive function and cardiovascular outcomes: The role of memory in hypertension. J Hypertension. 2022;40(XX):3-9.

Miller S, Davis B. The impact of emotional suppression on social support and health in hypertensive individuals. J Health Psychol. 2020;35(XX):345-52.

Gross JJ. Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology. 2002;39(3):281-91. DOI: https://doi.org/10.1017/S0048577201393198

Patel N, Clarke L. The relationship between cognitive performance and social support in hypertensive patients. J Psychosomatic Res. 2020;44(XX):211-8.

King R, Davis M, Brooks D. Cognitive flexibility and its role in hypertension management: The importance of social support. Int J Behavioral Med. 2019;29(XX):413-21.

Taylor J, Green M, Harris R. Cognitive function and the role of social support in managing hypertension. J Psychosomatic Res. 2021;45(XX):157-64.

Smith L, Brown D, White M. Exploring self-care management and functional social support in hypertensive patients. Int J Hypertension. 2022;29(XX):245-54.

American Heart Association. Hypertension. 2023. Available at: https://www.heart.org/en/health-topics/high-blood-pressure. Accessed on 25 June 2025.

American Heart Association. Understanding high blood pressure. 2023. Available at: https://www.heart.org. Accessed on 25 June 2025.

American Heart Association. Understanding blood pressure readings. 2023. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings. Accessed on 25 June 2025.

Harvard Health Publishing. Hypertension and the brain. 2020. Available at: https://www.health.harvard.edu. Accessed on 25 June 2025.

Jariyasakulwong P, Wattanakitkrileart D, Pongthavornkamol K, Piaseu N, Roubsanthisuk W. Factors influencing self-care practices and blood pressure among individuals with uncontrolled hypertension: A cross-sectional study. Patient Preference Adherence. 2025;19:1-17. DOI: https://doi.org/10.2147/PPA.S497555

Lazarus RS, Folkman S. Stress, appraisal, and coping. Springer Publishing Company. 1984.