5/16/2007 From Reuters:

Anxiety increases death risk in heart patients

NEW YORK (Reuters) — Anxiety appears to increase the risk of heart
attacks and death in patients who have coronary artery disease, U.S.
researchers report.

Coronary artery disease is caused by plaque build-up on the inside walls
of the arteries that supply blood and oxygen to the heart, causing them
to harden and narrow. This can lead to heart attack, angina (chest pain)
and other serious complications.

A number of studies have looked at the toll that mental stress takes on
cardiac health, but most have focused on depression, not anxiety. The
few studies that have examined the role that anxiety might play in heart
disease have usually measured anxiety only once, not over the course of
time, according to a report in the Journal of the American College of

This study involved 516 patients with heart disease who completed a
standard anxiety questionnaire annually for an average of 3.4 years. The
study group was 82 percent male with an average age of 68 years.

A total of 44 nonfatal heart attacks and 19 deaths occurred during the
study period, Dr. Charles M. Blatt, from Harvard Medical School in
Boston, and colleagues found.

A high cumulative anxiety score was associated with an elevated risk of
both heart attack and death from any cause, whereas the initial anxiety
score was not. Subjects with average anxiety scores in the highest 25
percent were nearly twice as likely to die of a heart attack or death
from any cause compared with those with scores in the lowest 25 percent.

Upon further analysis of the data, in which the researchers factored in
the effects of high blood pressure, diabetes, and other known
cardiovascular risk factors, each unit increase in the overall anxiety
score increased the odds of nonfatal heart attack or death by 6 percent.

Initial anxiety scores failed to predict negative patient outcomes,
“suggesting that assessing anxiety regularly over the long term is
necessary,” the authors conclude. Randomly assigned clinical studies are
now needed to see whether treatment to reduce anxiety can improve the
outcome of patients with coronary artery disease.