Among patients with heart disease, anxiety disorders appear to be associated with a higher risk of stroke, heart attack, heart failure and death, according to a report in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
As many as 24 percent to 31 percent of patients with heart disease also have symptoms of anxiety, according to background information in the article. "Compared with the extensive literature on depression in patients with coronary heart disease, relatively few studies have examined the role of anxiety," the authors write. "Several studies have found that anxiety symptoms are predictive of disability, increased physical symptoms and worse functional status and quality of life in patients with coronary heart disease. However, studies examining anxiety as a risk factor for future coronary heart disease have yielded conflicting results."
Elisabeth J. Martens, Ph.D., of Tilburg University, Tilburg, the Netherlands, and colleagues assessed 1,015 outpatients with stable coronary heart disease. The baseline examination consisted of interviews, blood and urine sample testing, exercise testing and electrocardiography. The presence of generalized anxiety disorder and of depressive disorder was determined using the computerized version of the Diagnostic Interview Schedule.
After an average follow-up time of 5.6 years, a total of 371 cardiovascular events occurred. After adjusting for age, the yearly rate of cardiovascular events was 9.6 percent in the 106 participants with general anxiety disorder and 6.6 percent in the 909 participants without. After further adjustments for potentially confounding variablesincluding sex, co-occurring conditions, heart disease severity and medication usegeneralized anxiety disorder was associated with a 74 percent increased risk of cardiovascular events.
"This leaves the question of why generalized anxiety disorder is associated with adverse outco
|Contact: Elisabeth J. Martens, Ph.D.|
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