Anxiety disorders and onset of cardiovascular disease: The differential impact of panic, phobias and worry

• Especially GAD substantially increased the risk for onset of CVD (adjusted OR: 3.39; 95% CI: 1.30–8.84).
• Also male gender, living without a partner, smoking and diabetes mellitus were significantly associated with onset of CVD.
• If underlying biological pathways can be altered, treating patients with GAD may contribute to the prevention of CVD.

Anxiety has been linked to onset of cardiovascular disease. This study examines the differential impact of types of anxiety (panic, phobia and worry) on 3-year onset of non-fatal cardiovascular disease (CVD). By investigating anxiety disorders as opposed to anxiety symptoms and by using a reliable diagnostic instrument to assess anxiety, limitations of previous studies are considered.5149 persons at risk for CVD were interviewed using the Composite International Diagnostic Interview. The panic-type included panic disorder and panic attacks; the phobic-type included agoraphobia and social phobia, and the worry-type included generalized anxiety disorder. CVD was self-reported and required treatment or monitoring by a doctor. Analyses were adjusted for sociodemographics, behavioral variables, and comorbid somatic and psychiatric disorders. During follow-up, 62 persons (1.2%) developed CVD. Baseline generalized anxiety disorder was strongly associated with onset of CVD (adjusted OR: 3.39). Further research should replicate findings and focus on biological underpinnings of this association.