NEW YORK (Reuters Health) - An anxious disposition is a strong, independent predictor of a heart attack in older men, according to a report in the Journal of the American College of Cardiology.
This study is not the first to link anxiety with heart attack, but there were some important differences from past research.
"In contrast with previous studies, not only did we demonstrate that anxiety characteristics predicted heart attack incidents over time, independent of biomedical and lifestyle risk factors, we also showed that this relationship could not be explained by other psychological factors examined in prior research, including type A personality, anger, hostility, and depression," lead author Dr. Biing-Jiun Shen told Reuters Health.
Differences from prior studies included using multiple measures of anxiety and a more defined outcome - heart attack, as opposed to coronary artery disease in general, added Shen, who is from the University of Southern California in Los Angeles.
The researchers evaluated 735 men who were an average 60 years old and had no coronary disease or diabetes at study entry. Tests that measured four characteristics of anxiety - psychasthenia (obsessive thoughts, irrational compulsions and excessive doubts); manifest anxiety (physical reaction to stress); social introversion; and phobias -- were used to generate an overall anxiety score.
For each standard deviation increase in the scores for psychasthenia, social introversion, phobia, and manifest anxiety, the heart attack risk increased by 37 percent, 31 percent, 36 percent, and 42 percent, respectively.
For each standard deviation increase in the overall anxiety score, the risk of heart attack rose by 43 percent. The results of further analysis confirmed the independent nature of these associations.
Although more studies are needed, Shen suggests that doctors may want to consider "chronic, pervasive, and unabated anxiety as a risk factor for heart attack among older men."
"At the risk of jumping to conclusions...I would also suggest that for older men with high anxiety, it may not be a bad idea to seek treatment."
Shen said his group would like to conduct similar research in women and in various ethnic groups, as well as investigate the possible mechanisms underlying these associations.
SOURCE: Journal of the American College of Cardiology for January 15, 2008.
Reuters Health
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