While there is a well-known relationship between major depression
and cardiovascular disease, much less is known about how anxiety
disorders affect the heart. Various studies have found that 24% to
31% of patients with cardiovascular disease have symptoms of
anxiety. Moreover, severe anxiety — which may manifest as a panic
attack — can mimic a heart attack. One analysis of studies
involving people admitted to emergency rooms for chest pain found
that 22% of those who underwent cardiovascular testing had panic
disorder rather than heart disease.
Most research on anxiety and heart disease is flawed, relying on
participants' recollections or single objective "snapshot"
assessments rather than using structured interviews to diagnose
anxiety. Many studies have also lacked controls for factors such as
lifestyle that could affect heart disease risk.
Two prospective studies followed large numbers of participants over
time to better examine the relationship between heart disease and
one of the most common anxiety disorders, generalized anxiety
disorder — characterized by constant and pervasive anxiety, even
about mundane matters. A particular strength of these studies is
that they controlled for confounding factors such as major
depression (which often occurs in conjunction with anxiety) and
demographic and lifestyle factors that affect heart disease risk.
Both suggest that generalized anxiety disorder may indeed increase
risk of heart attacks and other adverse events.
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