Anxiety, Depression May Triple Risk of Death for Heart Patients: Study

Researcher recommends stress-reducing measures

By Steven Reinberg

HealthDay Reporter

TUESDAY, March 19 (HealthDay News) -- Anxiety and depression coupled with heart disease triples the risk of death compared to cardiac trouble alone, researchers have found.

Among heart patients, anxiety can double the risk of dying from any cause, the study authors noted, and depression further raises those odds.

"Patients with heart disease who experience high anxiety during the stressors of everyday life may benefit from treatments designed to reduce anxiety, such as medications targeting anxiety or stress management," said lead researcher Lana Watkins, an associate professor of psychiatry and behavioral sciences at Duke University Medical Center in Durham, N.C.

"Benefits from stress-reducing interventions would potentially be greatest in patients where anxiety is found in combination with depression," she added.

Previous studies have shown that depression is about three times more common in heart attack patients than in others. But few studies have looked at anxiety's effect or the combination of the two on heart disease patients.

One expert, Dr. Gregg Fonarow, a spokesman for the American Heart Association and a professor of cardiology at the University of California, Los Angeles, agreed anxiety and depression are most lethal when they co-exist.

"Depression and anxiety have both been individually associated with a higher risk of developing cardiovascular disease, and in patients with cardiovascular disease [they are] associated with higher risk of recurrent cardiovascular events and death," Fonarow said.

This new study finds that anxiety, particularly when accompanying depression, independently increased risk of dying, he added.

The report was published March 19 in the Journal of the American Heart Association.

Anxiety is a common mental health problem, with about one-third of U.S. adults experiencing an anxiety disorder in their lifetime, the researchers noted. And heart disease is the leading cause of death in the United States.

For the study, more than 900 heart disease patients, average age 62, answered a questionnaire measuring their level of anxiety and depression right before or just after coronary angiography, which can be a stressful cardiac procedure. The test uses special X-rays and dyes to view the coronary arteries.

The investigators found that 90 patients had anxiety, 65 had depression and 99 suffered from both.

Of the 133 patients who died over the three years of follow-up, 55 suffered from anxiety, depression or both, the researchers reported. Most of these deaths (93) were related to heart disease, they noted.

Patients who are highly anxious during a stressful life experience, such as a cardiac hospitalization, are at an increased risk of dying, and this risk is independent of the severity of their heart disease and also of depression, Watkins said.

According to the researchers, anxiety can increase inflammation and blood pressure. Fatigue or feelings of worthlessness associated with depression may cause people to ignore their treatment for heart disease.

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