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Here's something
new to worry about: Anxiety hikes heart
attack risk…New research shows intense,
long-lasting anxiety increases risk by 30 to
40 percent
We all know that people
with a Type A personality and an
off-the-charts hostility level may be
courting a heart attack.
But this might come as
a surprise: New research shows that their
nervous, socially withdrawn neighbors also
have reason to worry.
The research, published
in the January 15, 2008, issue of the
Journal of the American College of
Cardiology (JACC), shows that longstanding
anxiety markedly increases the risk of heart
attack, even when other common risk factors
are taken into account.
“What we’re seeing is
over and beyond what can be explained by
blood pressure, obesity, cholesterol, age,
cigarette smoking, blood sugar levels and
other cardiovascular risk factors,” said
Biing-Jiun Shen, Ph.D., an assistant
professor of psychology at the University of
Southern California in Los Angeles.
The role of anxiety in
hiking heart attack risk also goes beyond
the effects of depression, anger, hostility,
Type A behavior and other negative emotions.
“These psychological factors are important
in predicting the risk of heart disease, but
anxiety is unique,” Dr. Shen said.
“Older
men with sustained and pervasive anxiety
appear to be at increased risk for a heart
attack even after their levels of
depression, anger, hostility and Type A
behavior are considered.”
For the study, Dr. Shen
and his colleagues analyzed data from the
Normative Aging Study, which was designed to
assess medical and psychological changes
associated with aging among a group of
initially healthy men.
Each of the 735 men
participating in the new analysis completed
psychological testing in 1986 and was in
good cardiovascular health at the time.
Although most people
think of anxiety as intense worry, Dr. Shen
and his colleagues looked much deeper,
examining four different measures of
anxiety. The first anxiety scale measured
psychasthenia, or excessive doubts,
obsessive thoughts and irrational
compulsions.
The second anxiety scale
measured social introversion, or anxiety,
insecurity, and discomfort in interpersonal
and social situations.
The third anxiety
scale measured phobias, or excessive
anxieties or fears about animals, situations
or objects.
The fourth anxiety scale,
manifest anxiety, measured the tendency to
experience tension and physical arousal in
stressful situations.
Separate sections of
the psychological test measured hostility,
anger, Type A behavior, depression, and
negative emotions. Study participants also
completed questionnaires about health habits
such as smoking, alcohol consumption and
daily diet, and had a medical exam every
three years over a follow-up period that
averaged more than 12 years.
The investigators found
that men who tested at the highest 15th
percentile on any of the four anxiety
scales, as well as on a scale combining all
four, faced an increase in the risk of heart
attack of approximately 30 to 40 percent.
Those who were found to have even higher
levels of anxiety on psychological testing
faced an even higher risk of heart attack.
This finding held true even after the
findings were adjusted for standard
cardiovascular risk factors, health habits,
and negative psychological and personality
traits.
“The good thing about
anxiety is that it’s very treatable,” said
Dr. Shen. “If someone is highly anxious—if
they’re suffering from panic attacks or
social phobia or constant worry—we recommend
therapy. Although more research is needed,
we hope that by reducing anxiety, we can
lower the future risk of heart attack. This
is one more reason to seek help.”
Dr. Shen said the new
research does not address the role of
anxiety in provoking heart attacks in women.
He and his colleagues are considering such a
study in the future.
###
Dr. Shen reports no
conflicts related to this study, which was
supported by a grant from the American Heart
Association and an award from the National
Alliance for Research on Schizophrenia and
Depression.
The American College of
Cardiology is leading the way to optimal
cardiovascular care and disease prevention.
The College is a 34,000-member nonprofit
medical society and bestows the credential
Fellow of the American College of Cardiology
upon physicians who meet its stringent
qualifications. The College is a leader in
the formulation of health policy, standards
and guidelines, and is a staunch supporter
of cardiovascular research. The ACC provides
professional education and operates national
registries for the measurement and
improvement of quality care. More
information about the association is
available online at
www.acc.org .
The American College of
Cardiology (ACC) provides these news reports
of clinical studies published in the Journal
of the American College of Cardiology as a
service to physicians, the media, the public
and other interested parties. However,
statements or opinions expressed in these
reports reflect the view of the author(s)
and do not represent official policy of the
ACC unless stated so.
