Anxiety Rises Risk of Heart Attack

Patients whose anxiety intensified over time were in greatest peril, while those who started out highly anxious but later found inner calm markedly reduced their risk. “Most patients come in very anxious about their coronary condition,” said Charles M. Blatt, M.D., clinical professor of medicine at Harvard Medical School. “I’m convinced that spending time with the patient and the family and interacting with them as a caring human being is critically important to clinical outcomes.”

For the study, Dr. Blatt and his colleagues recruited 516 patients with proven coronary artery disease (CAD). At the beginning of the study and again each year patients completed a standardized questionnaire about their feelings during the previous week, for example, whether they felt peaceful, felt something bad would happen, took a long time to fall asleep at night, or had upset bowels or stomach.

Patients were followed-up for an average of more than 3 years. During that time, 19 patients died and 44 had a nonfatal heart attack. Cumulative anxiety scores were averaged and adjusted for age, and the patients divided into 3 groups. Those with anxiety scores in the highest third had nearly double the risk of heart attack or death when compared to those with anxiety scores in the lowest third (hazard ratio, 1.97; p=0.04). Looked at from another angle, the data showed a 6 percent increase in the risk of death or heart attack each time the average cumulative anxiety scored notched up by 1 unit (p=0.02).

The initial anxiety score alone offered little clue to the patient’s future health. However, an increase in anxiety over time hiked the risk of heart attack or death by 10 percent (p<0.001). Conversely, patients whose anxiety level was in the highest third at baseline, but in the lowest third when cumulative average anxiety levels were tallied, were among the least likely to have a heart attack or to die.; Source: American College of Cardiology