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The research included over 1,000 people with stable coronary heart disease who were assessed for anxiety disorder at the start of the study and then followed for an average of 5.6 years.
During that time, there were a total of 371 cardiovascular events (heart attacks or other incidents that may cause damage to the heart). The yearly rate of cardiovascular events was 9.6% among the 106 patients with generalized anxiety disorder and 6.6% among the other 909 patients.
After adjusting for a number of factors -- such as other health problems, heart disease severity and medication use -- the researchers concluded that generalized anxiety disorder was associated with a 74% increased risk of cardiovascular events.
Many factors may account for the increase in risk, wrote Elisabeth J. Martens, of Tilburg University in the Netherlands, and colleagues. Anxiety may be linked with surges in "fight or flight" hormones called catecholamines that may be related to heart risks, or people with anxiety may be more likely to seek medical care when they have symptoms of a cardiovascular event (although researchers noted this wouldn't explain the higher rates of death). It's also possible that a common underlying factor may increase the risk of both anxiety and heart events.
The study appears in the July issue of the journal Archives of General Psychiatry.
"These findings have implications for clinical practice and research," Martens and colleagues concluded in a news release, since the evaluation and treatment of anxiety might now "be considered as part of the comprehensive management of patients with coronary heart disease."
They added that scientists need research programs to help understand the impact of anxiety disorders on medical prognosis, including that of heart disease, and to develop evidence-based approaches to patient care.
-- Robert Preidt
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SOURCE: JAMA/Archives journals, July 5, 2010, news release.