2006 Katharine A. Lembright Award—“The Thin Stream of Fear Trickling Through the Mind”: Impact of Anxiety in Cardiac Patients
Anxiety has both functionally appropriate and pathological consequences. Among people with cardiac disease, anxiety can be functionally appropriate when it triggers an individual to quickly seek treatment for acute cardiac symptoms. Anxiety, however, may have pathological consequences when it is persistent or severe. These consequences may include the following: difficulty adhering to prescribed treatments and making recommended lifestyle changes; adoption of or failure to change risky behaviors; increased risk for acute cardiac events; and increased risk for in-hospital complications after admission for acute coronary syndrome. Nevertheless, because anxiety is a universal emotion that is managed without consequence by many people, its significance is often ignored by healthcare providers. The purpose of this presentation is to describe findings from a biobehavioral program of research in which the impact of psychosocial (with a major emphasis on anxiety) and behavioral variables on biological outcomes has been systematically examined. In this program of research we have (1) examined and compared the intensity of anxiety in international samples of various cardiac patient groups; (2) determined gender differences in the expression of anxiety; (3) investigated factors predicting anxiety levels, including perceived control; (4) studied healthcare providers’ knowledge of anxiety assessment and their practices with regard to the assessment and management of anxiety; (5) determined the impact of anxiety on clinical outcomes in cardiac patients and elucidated mechanisms for the linkage; and (6) tested interventions to decrease anxiety and improve morbidity and mortality. We hope to improve patient outcomes on a widespread basis by placing anxiety in the forefront of clinical cardiac practice.