Circulation, Vol 90, 2225-2229, Copyright © 1994 by American Heart Association
I Kawachi, D Sparrow, PS Vokonas and ST Weiss
BACKGROUND--Several studies have suggested an increased risk of fatal
coronary heart disease (CHD) among patients with panic disorder, phobic
anxiety, and other anxiety disorders. We prospectively examined this
association in the Normative Aging Study. METHODS AND RESULTS--An anxiety
symptoms scale was constructed out of five items from the Cornell Medical
Index, which was administered to the cohort at baseline. During 32 years of
follow-up, we observed 402 cases of incident coronary heart disease (137
cases of nonfatal myocardial infarction, 134 cases of angina pectoris, and
131 cases of fatal CHD-- made up of 26 cases of sudden cardiac death and
105 cases of nonsudden death). A nested case-control design (involving 1869
control subjects who remained free of diagnosed CHD) was used to assess the
association between anxiety and risk of CHD. Compared with men reporting no
symptoms of anxiety, men reporting two or more anxiety symptoms had
elevated risks of fatal CHD (age-adjusted odds ratio [OR] = 3.20, 95%
confidence interval [CI]: 1.27 to 8.09), and sudden death (age-adjusted OR
= 5.73, 95% CI: 1.26 to 26.1). The multivariate OR after adjusting for a
range of potential confounding variables was 1.94 (95% CI: 0.70- 5.41) for
fatal CHD and 4.46 (95% CI: 0.92-21.6) for sudden death. No excess risks
were found for nonfatal myocardial infarction or angina. CONCLUSIONS--These
data suggest an association between anxiety and fatal coronary heart
disease, in particular, sudden cardiac death.
ARTICLES
Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115.
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 Anxiety Is a Risk Factor for Sudden Death Journal Watch Cardiology, January 1, 1995; 1995(101): 15 - 15. [Full Text]
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 ANXIETY IS A RISK FACTOR FOR SUDDEN DEATH Journal Watch (General), November 22, 1994; 1994(1122): 3 - 3. [Full Text]
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