Older men, with no previous history of heart disease, increase their risk of a heart attack by as much as 40 per cent if they have longstanding anxiety problems. Research published in the January issue of the American College of Cardiology points to anxiety as a key risk factor and one that is independent of other common risk factors.
“What we are 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 Professor Biing-Jing Shen, Ph.D., the author of the report.
A sample of 735 men with an average age of 60 and no history of coronary heart disease or diabetes, were assessed on four different measures of anxiety, from the Minnesota Multiphasic Personality Inventory (MMPI). At the outset of the study in 1986, participants also received a physical examination and blood tests. Similar tests were conducted every three years. Most participants were Caucasian (97%) aged between 42 and 87. Most were married and most (68%) had more than a high school education.
The MMPI provides a detailed assessment of enduring personality patterns. The four scales used in the study assessed:
- Psychasthenia: excessive doubts, obsessive ruminations & irrational compulsions.
- Social Introversion: insecurity and discomfort in social and interpersonal situations.
- Phobia: fear of specific animals, situations or objects.
- Manifest Anxiety: the predisposition to experience physical discomfort and symptoms associated with anxiety in stressful situations.
The research also included other measures with known associations to heart disease such as type A behavior, hostility, anger, depression and negative emotions. Additional health-related information was gathered in relation to calorie intake, smoking and alcohol consumption.
By 2004, 75 of the participants had experienced a heart attack of which 11 died or subsequently died. Analysis of the findings shows that older men with anxiety-prone dispositions constitute a robust and independent risk factor in the prediction of heart attacks. Interpersonal and social difficulties appear to constitute a major source of distress. Men with higher levels of anxiety have an associated higher risk of heart attack.
But it’s not all doom and gloom. “The good thing about anxiety is that it’s very treatable,” said Professor Shen. Future work now needs to consider women, ethnic minorities, and clinical populations.
Source:
Shen, B-J., Avivi, Y. E., Todaro, J.F., Spiro, A., Laurenceau, J-P., Ward, K.D., Niaura, R. (2008) Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men: the unique contribution of anxiety among psychologic factors. Journal of the American College of Cardiology. 51(2) 113-9.
