After weighting, a total of 74,285,160 individuals were represented in our cohort. The demographics of the sample are outlined in Table 1. Descriptive statistics evaluated the prevalence of depressive and anxiety-related symptoms in low-income respondents with hypertension. In respondents with hypertension (N = 22,444,743), a total of 5,549,017 (25%) reported taking medication for depression, and 4,750,688 (9.2%) indicated taking medications for anxiety. In participants without hypertension (N = 51,840,417), depression (N = 4,750,688; 9.2%) and anxiety (N = 5,280,174; 10%) medications were less frequently reported (P < 0.001).

In participants with hypertension, 6,017,850 individuals (27%) reported feeling anxious/worried daily, 3,411,416 (15%) weekly, 2,679,225 (12%) monthly, 6,351,775 (28%) a few times a year, and 3,984,476 (18%) never. In respondents without hypertension, 10,648,236 individuals (21%) felt anxious/worried daily, 8,903,487 (17%) weekly, 6,151,302 (12%) monthly, 14,703,338 (28%) a few times a year, and 11,434,055 (22%) never. Chi-squared and Wilcoxon rank sum analyses did not find any significant difference (P = 0.2) between the two groups.

In hypertension participants, 2,636,813 (12%) reported depressive feelings daily, 2,768,778 (12%) weekly, 2,297,698 (10%) monthly, 8,160,506 (36%) a few times a year, and 6,580,948 (29%) never. In respondents without hypertension, 3,750,062 (7.2%) reported depressive feelings daily, 5,204,861 (10%) weekly, 5,042,188 (9.7%) monthly, 14,789,490 (29%) a few times a year, and 23,053,816 (44%) never. A significant difference in frequencies was identified on chi-squared and rank sum analyses (P < 0.001).

From our multivariate logistic regression, we found that participants who reported taking depression medication had greater odds of being diagnosed with hypertension (OR 2.72; 95% CI 1.41–5.24; P = 0.009). The findings of our regressions are outlined in Table 2. Compared with participants who never reported feeling depressed, individuals with daily feelings of depression (OR 2.52; 95% CI 1.43–4.43; P = 0.011), monthly feelings (OR 2.40; 95% CI 1.02–5.63; P = 0.046) or feelings a few times a year (OR 2.22; 95% CI 1.40–3.54; P = 0.009) had greater odds of hypertension. Weekly feelings of depression approached significance (OR 2.16; 95% CI: 0.99–4.74; P = 0.052). Similarly, participants taking anxiety medication had greater odds of having been diagnosed with hypertension (OR: 2.50; 95% CI: 1.42–4.41; P = 0.006). Participants with daily (OR: 2.28; 95% CI: 1.22–4.24; P = 0.021) and weekly (OR: 1.88; 95% CI: 1.05–3.38; P = 0.040) symptoms of anxiety had greater odds of hypertension than those who never experienced symptoms. Each unit increase in age was associated with greater risk for hypertension (OR: 1.06; 95% CI: 1.05–1.07; P < 0.001).