Clinical Scorecard: The Impact of Psychological Stress on Diastolic Blood Pressure Among Cardiology Outpatients: Findings from a Multicenter Cross-Sectional Study (ABC2X-2026)

At a Glance

Key Highlights

• 55% of patients reported psychological stress, with 39% having present stress.
• Present stress is associated with higher diastolic blood pressure (DBP).
• The association between present stress and DBP is stronger in older patients and those with coronary artery disease (CAD).
• Previous stress does not significantly impact diastolic blood pressure.
• Routine assessment of psychological stress may enhance cardiovascular risk stratification.

Guideline-Based Recommendations

Diagnosis

• Psychological stress should be assessed through structured clinical interviews.

Management

• Integrate psychological stress evaluation into cardiovascular risk assessment.

Monitoring & Follow-up

• Monitor diastolic blood pressure in patients with present psychological stress.

Risks

• Ongoing psychological stress is an independent risk factor for elevated diastolic blood pressure.

Patient & Prescribing Data

675 adult patients undergoing first outpatient evaluation.

Anxiolytic treatment was noted among patients with present stress.

Clinical Best Practices

• Conduct routine psychological stress assessments in cardiology outpatient settings.
• Differentiate between present and previous stress during evaluations.

Related Resources & Content

• ESC Guidelines 2016 and 2021
• 2025 ESC Clinical Consensus Statement
• INTERHEART Study