Investigating the Mediating Role of Psychological Distress in the Relationship between Perceived Social Support and Primary Blood Pressure in Elementary and High School Teachers

 Hypertension, also recognized as blood pressure or arterial hypertension, is a chronic disease caused by high blood pressure in the arteries. High blood pressure due to complications and its associated high death rate is a major health problem that affects individuals’ quality of life. Psychological distress is a risk factor for hypertension. Improperly controlled stress can lead to physical ailments, such as cardiovascular disease and hypertension. Research suggested that psychological distress and social support are associated with generating hypertension and its correlations, such as coronary heart disease. The present study aimed to determine the mediating role of psychological distress in the relationship between perceived social support and primary blood pressure in teachers.

 This descriptive study employed structural equation modeling. The statistic population of this study consisted of all teachers of Astara City, Iran, with the diagnosis of primary hypertension in 2019. Using the convenience and voluntary sampling method, 200 number subjects were selected among them. The inclusion criteria included primary blood pressure greater than 14.9 mmHg and an age range of 30 to 65 years. The exclusion criteria of the research consisted of drug use, concurrent biopsychological illnesses, and receiving psychotherapy and other interventions over the past year. The study tools included the Depression, Anxiety, Stress Scale–Short Form (DASS–21) (Lovibond & Lovibond, 1995) and Multidimensional Scale of Perceived Social Support (Zimet et al., 1988) and specialists’ diagnoses inclusive score of primary hypertension of subjects. Structural equation modeling and Pearson correlation coefficient were applied in AMOS and SPSS to analyze the collected data. The significance level of the tests was considered 0.01.

 The obtained results indicated that the total path coefficient (the sum of direct & indirect path coefficients) related to the effect of perceived social support on blood pressure was negative and significant (β=–0.161, p=0.002). The direct path coefficient of the relationship between psychological distress and blood pressure was positive and significant (β=0.412, p=0.003). The direct path coefficient of the relationship between perceived social support with blood pressure was negative and significant (β=–0.392, p=0.001). The direct path coefficient of the relationship between perceived social support and psychological distress was negative and significant (β=–0.641, p=0.001). The indirect path coefficient between perceived social support with blood pressure was positive and significant (β=0.251, p=0.003). Furthermore, the hypothesized model had fitness with the collected data (χ2=36.579, CFI=0.971, GFI=0.958, AGFI=0.911 and RMSEA=0.076).

 Teachers who receive limited social support are more stressed, depressed, and anxious. Accordingly, they have a weaker immune system and higher levels of cortisol. Finally, they are prone to hypertension in the long run.