Patients with heart disease who also suffer from an anxiety disorder have a significantly higher risk of having a heart attack, heart failure, stroke and death, compared to other heart disease patients, according to Dutch scientists.

You can read about this study in the peer-reviewed medical journal Archives of General Psychiatry.

Researchers from Tilburg University, The Netherlands studied over 1,000 patients with heart disease. They found that those who also had an anxiety disorder had a 74% higher chance of developing a cardiovascular event, such as heart attack, stroke or heart failure.

  • What is a heart attack? – if the heart muscle does not have enough blood (and consequently oxygen) it dies and a heart attack occurs. Another name for a heart attack is myocardial infarction, cardiac infarction and coronary thrombosis.
  • What is heart failure? – a serious condition in which the heart is not pumping blood around the body efficiently. The patient’s left side, right side, or even both sides of the body can be affected. Symptoms will depend on which side is affected and how severe the heart failure is – symptoms can be severe.
  • What is a stroke? – a condition where a blood clot or ruptured artery or blood vessel interrupts blood flow to an area of the brain. A lack of oxygen and glucose (sugar) flowing to the brain leads to the death of brain cells and brain damage, often resulting in an impairment in speech, movement, and memory.

The scientists monitored the patients for approximately 5.5 years. They found that the annual rate of a cardiovascular event was:

  • 9.6% among the patients who suffered from a general anxiety disorder (106 of them)
  • 6.6% among the patients who did not have a general anxiety disorder (909 of them)

The researchers revealed that although up to nearly one third of all patients with heart disease present anxiety signs and symptoms, there were hardly any studies that examined a link between anxiety and cardiovascular events.

Why anxiety increases the risk of complications is not fully understood, say the authors. Perhaps patients with a general anxiety disorder are better diagnosed for cardiovascular events, because they are more likely to see a doctor when symptoms are felt. It could also be the other way round; patients with heart disease who are also extremely anxious may not see their specialist, and suffer from complications because of lack of targeted treatment. Another possibility is that the combination of heart disease and high anxiety is a risk factor for cardiovascular events.

Lead author, Dr. Elisabeth Martens said:

“Evaluation and treatment of anxiety may also be considered as part of the comprehensive management of patients with coronary heart disease.”

“Scared to Death? Generalized Anxiety Disorder and Cardiovascular Events in Patients With Stable Coronary Heart Disease”
The Heart and Soul Study
Elisabeth J. Martens, PhD; Peter de Jonge, PhD; Beeya Na, MPH; Beth E. Cohen, MD, MAS; Heather Lett, PhD; Mary A. Whooley, MD
Arch Gen Psychiatry. 2010;67(7):750-758.

Written by Christian Nordqvist