The Impact of Hypertension on Mental Health Among Older People in South Asia: A Systematic Literature Review

Background: Hypertension is a highly prevalent chronic condition among older adults and represents a major public health challenge in South Asia. Beyond its well-established cardiovascular consequences, growing evidence suggests that hypertension is closely associated with adverse mental health outcomes, including depression, anxiety, and cognitive impairment. However, existing evidence remains fragmented and insufficiently synthesised within the unique sociocultural, economic, and healthcare contexts of South Asia. Aim: This systematic literature review aimed to synthesise and critically evaluate empirical evidence on the impact of hypertension on mental health outcomes among older adults in South Asian countries. Methods: A systematic literature review was conducted in accordance with PRISMA 2020 guidelines. Searches were performed through PubMed/MEDLINE and ScienceDirect databases for peer-reviewed studies published between 2010 and 2025. Eligibility criteria included quantitative and qualitative studies examining hypertension and mental health outcomes (depression, anxiety, cognitive impairment, or psychological wellbeing) among adults aged ≥35 years residing in South Asia. Ten studies met the inclusion criteria. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools and the Critical Appraisal Skills Programme (CASP) checklists. Data were synthesised using thematic analysis guided by Braun and Clarke’s framework. Results: The review identified a consistent association between hypertension and increased psychological distress among older adults in South Asia. Five overarching themes emerged: (1) heightened prevalence of depression, anxiety, and emotional distress among hypertensive individuals; (2) hypertension-related cognitive decline mediated by vascular and lifestyle mechanisms; (3) socioeconomic disadvantage and demographic factors influencing both hypertension control and mental health outcomes; (4) gender and sociocultural norms shaping illness experience, symptom reporting, and help-seeking behaviours; and (5) the moderating role of coping strategies, family support, and health-system responsiveness. Despite methodological heterogeneity, findings were largely consistent across countries. Conclusion: Hypertension exerts a significant negative impact on mental health among older adults in South Asia, amplified by social inequities, cultural stigma, and fragmented healthcare systems. The findings highlight the urgent need for integrated, culturally sensitive models of care that address both cardiovascular and mental health needs within primary healthcare settings. Future research should prioritise longitudinal designs and intervention studies to inform evidence-based policy and practice in resource-limited contexts.

Name dc:type.qualificationname

msc

Level dc:type.qualificationlevel

masters

Grantor dc:publisher.institution

University of Wales Trinity Saint David

Year dc:date.issued

2026

Author dc:creator

• Begum, Mst Halima

• BF Seicoleg
• RC Meddygaeth fewnol

Dc Identifier Grantnumber

UWTSD

OAI identifier oai:identifier

oai:repository.uwtsd.ac.uk:4207