Anxiety Symptoms Assessed by the Goldberg Anxiety and Depression Scale, Lifestyle Habits, and Cardiometabolic Risk in Spanish Workers
6 affiliations
- 1Home Hospitalization Unit, Arnau de Vilanova Hospital, 46015 Valencia, Spain
- 2Faculty of Medicine, University of Castilla La Mancha (UCLM), 02008 Albacete, Spain
- 3ADEMA-University School, University of the Balearic Islands, 07009 Palma, Spain
- 4Abascal Legal Medicine Group, 28003 Madrid, Spain
- 5Primary Care, Balearic Islands Health Service, 07010 Palma, Spain
- 6Faculty of Medicine, University of the Balearic Islands, 07120 Palma, Spain
Abstract
Background:: Anxiety has been increasingly recognized as a relevant contributor to cardiometabolic dysfunction through neuroendocrine, inflammatory, and behavioral mechanisms. However, evidence evaluating the relationship between anxiety symptoms, lifestyle habits, and cardiometabolic risk in large occupational populations remains limited. This study aimed to analyze the association between Goldberg Anxiety and Depression Scale (GADS) scores, lifestyle behaviors, and cardiometabolic risk factors in a large cohort of Spanish workers.
Methods:: A cross-sectional observational study was conducted in 119,336 Spanish workers undergoing routine occupational health examinations between 2021 and 2023. Anxiety symptoms were assessed using the GADS. Lifestyle variables included smoking status, physical activity assessed with the International Physical Activity Questionnaire (IPAQ), and adherence to the Mediterranean diet evaluated through the Prevention with Mediterranean Diet (PREDIMED) questionnaire. Anthropometric measurements, blood pressure, lipid profile, fasting glucose, obesity, abdominal obesity, and metabolic syndrome were analyzed. Multivariable logistic regression models were used to estimate adjusted odds ratios (ORs) for cardiometabolic abnormalities according to anxiety status and lifestyle factors.
Results:: Elevated GADS scores were significantly associated with worse cardiometabolic profiles in both sexes, including higher blood pressure, triglycerides, fasting glucose, body mass index, waist circumference, and lower high-density lipoprotein cholesterol concentrations. Workers with elevated anxiety presented markedly higher prevalences of hypertension, hypertriglyceridemia, impaired fasting glucose, abdominal obesity, and metabolic syndrome (all p < 0.001). After multivariable adjustment, elevated anxiety remained independently associated with hypertension (OR 6.48; 95% confidence interval (CI) 5.89–7.09), hypertriglyceridemia (OR 5.31; 95% CI 4.60–6.02), and impaired fasting glucose (OR 5.23; 95% CI 4.64–5.83). Physical inactivity and low adherence to the Mediterranean diet were associated with a less favorable cardiometabolic profile among participants with elevated anxiety scores. Elevated GADS scores were independently associated with all major cardiometabolic outcomes after multivariable adjustment, with the strongest associations observed for hypertension, hypertriglyceridemia, and impaired fasting glucose.
Conclusions:: Elevated GADS scores are strongly associated with adverse cardiometabolic profiles in Spanish workers, particularly when combined with unhealthy lifestyle behaviors. These findings support the integration of mental health assessment and lifestyle interventions into occupational cardiometabolic prevention strategies.
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BibTeX
@article{sepulveda2026anxiety,
title = {{Anxiety Symptoms Assessed by the Goldberg Anxiety and Depression Scale, Lifestyle Habits, and Cardiometabolic Risk in Spanish Workers}},
author = {Lucía Garrido Sepúlveda and Pedro Juan Tárraga López and María Teófila Vicente-Herrero and José Alberto Garrido and Ángel Arturo López-González and José Ignacio Ramírez-Manent},
journal = {Actas Españolas de Psiquiatría},
year = {2026},
month = oct,
doi = {10.62641/aep.2356},
url = {https://doi.org/10.62641/aep.2356},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Anxiety Symptoms Assessed by the Goldberg Anxiety and Depression Scale, Lifestyle Habits, and Cardiometabolic Risk in Spanish Workers
AU - Lucía Garrido Sepúlveda
AU - Pedro Juan Tárraga López
AU - María Teófila Vicente-Herrero
AU - José Alberto Garrido
AU - Ángel Arturo López-González
AU - José Ignacio Ramírez-Manent
PY - 2026
DA - 2026/10/15
JO - Actas Españolas de Psiquiatría
DO - 10.62641/aep.2356
UR - https://doi.org/10.62641/aep.2356
AB - Background:: Anxiety has been increasingly recognized as a relevant contributor to cardiometabolic dysfunction through neuroendocrine, inflammatory, and behavioral mechanisms. However, evidence evaluating the relationship between anxiety symptoms, lifestyle habits, and cardiometabolic risk in large occupational populations remains limited. This study aimed to analyze the association between Goldberg Anxiety and Depression Scale (GADS) scores, lifestyle behaviors, and cardiometabolic risk factors in a large cohort of Spanish workers. Methods:: A cross-sectional observational study was conducted in 119,336 Spanish workers undergoing routine occupational health examinations between 2021 and 2023. Anxiety symptoms were assessed using the GADS. Lifestyle variables included smoking status, physical activity assessed with the International Physical Activity Questionnaire (IPAQ), and adherence to the Mediterranean diet evaluated through the Prevention with Mediterranean Diet (PREDIMED) questionnaire. Anthropometric measurements, blood pressure, lipid profile, fasting glucose, obesity, abdominal obesity, and metabolic syndrome were analyzed. Multivariable logistic regression models were used to estimate adjusted odds ratios (ORs) for cardiometabolic abnormalities according to anxiety status and lifestyle factors. Results:: Elevated GADS scores were significantly associated with worse cardiometabolic profiles in both sexes, including higher blood pressure, triglycerides, fasting glucose, body mass index, waist circumference, and lower high-density lipoprotein cholesterol concentrations. Workers with elevated anxiety presented markedly higher prevalences of hypertension, hypertriglyceridemia, impaired fasting glucose, abdominal obesity, and metabolic syndrome (all p < 0.001). After multivariable adjustment, elevated anxiety remained independently associated with hypertension (OR 6.48; 95% confidence interval (CI) 5.89–7.09), hypertriglyceridemia (OR 5.31; 95% CI 4.60–6.02), and impaired fasting glucose (OR 5.23; 95% CI 4.64–5.83). Physical inactivity and low adherence to the Mediterranean diet were associated with a less favorable cardiometabolic profile among participants with elevated anxiety scores. Elevated GADS scores were independently associated with all major cardiometabolic outcomes after multivariable adjustment, with the strongest associations observed for hypertension, hypertriglyceridemia, and impaired fasting glucose. Conclusions:: Elevated GADS scores are strongly associated with adverse cardiometabolic profiles in Spanish workers, particularly when combined with unhealthy lifestyle behaviors. These findings support the integration of mental health assessment and lifestyle interventions into occupational cardiometabolic prevention strategies.
SN - 1139-9287
SN - 1578-2735
ER -