Heart disease patients who struggle with anxiety have twice the risk of dying prematurely, compared to those without the mental-health condition, new research shows.
What’s more, the study published in the Journal of the American Heart Association found heart patients with both anxiety and depression have triple the risk of dying, compared to those without either condition.
The findings, by researchers at Duke University Medical Center, suggest better monitoring of heart patients for anxiety and depression could boost their survival odds.
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"Many studies have linked depression to an increased risk of death in heart disease patients," said lead researcher Lana Watkins, an associate professor in psychiatry and behavioral sciences at Duke. "However, anxiety hasn't received as much attention."
Past studies have shown depression is about three times more common in heart attack patients, which is why the American Heart Association recommends they be screened for depression and treated if necessary.
But depressed heart disease patients often also have anxiety, suggesting it may add to the risks previously attributed solely to depression, Watkins said.
"It's now time for anxiety to be considered as important as depression, and for it to be examined carefully," she said.
For the new study, 934 heart disease patients — average age 62 — completed a survey measuring their level of anxiety and depression before or after a cardiac procedure at Duke University Medical Center.
The results showed among the 133 patients who died during three years of follow-up, 55 had anxiety, depression or both. The majority of deaths (93 of 133) were heart-related.
Watkins explained that anxiety and depression increase risk of death in various ways.
Anxiety, for example, increases nervous system mechanisms that control blood pressure. Depression can also prompt patients to neglect medical advice and treatments, and engage in unhealthy behaviors like smoking and being sedentary.
Watkins said future studies should test strategies to manage anxiety and with depression in heart disease patients.
"Anxiety-reducing medications combined with stress management could improve outcome for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention involving more frequent outpatient monitoring and incentives to improve adherence," she said.
The study was funded, in part, by the National Institutes of Health.
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