A Systematic Review of the Causal Link between Stress and Hypertension with the Use of Hills Criteria of Causation

Research Paper (postgraduate) from the year 2013 in the subject Medicine - Public Health, grade: none, Madonna University Elele, Nigeria, course: Epidemiology, language: English, abstract: There is little or no doubt that stressful situations can cause significant rise in blood pressure. It is no news that a more chronic form of blood pressure is termed 'hypertension'. There is a need to discover whether the presence of stress really leads to the development over time. A systematic review of literature on stress and hypertension Studies reporting an association between stress and hypertension A systematic review was carried out to identify, evaluate and summarize the literature related to establishing a causal relationship between stress and hypertension with the use of Bradford-Hills criteria of causality. A search was carried out using CINAHL, MEDLINE, and Pub Med databases and their reference list of included study and other internet sources Keywords like stress, hypertension, plausibility, dose-response relationship, temporality, coherence, analogy, and epidemiology was used as the search criteria. The search yielded 10 studies with about 2,000 citations. 4 studies provided moderate evidence for the causation criterion and 6 studies provided strong evidence for the causal criterion. None of the studies agreed with specificity of causes as a criterion for determining that stress causes hypertensions and no study was found that suggests analogy between stress and hypertension. There is enough significant evidence to fulfill the basic criteria of causation as proposed by Austin Bradford Hill.