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Meta-analysis of anxiety as a risk factor for cardiovascular disease


Emdin, CA and Odutayo, A and Wong, CX and Tran, J and Hsiao, AJ and Hunn, BHM, Meta-analysis of anxiety as a risk factor for cardiovascular disease, American Journal of Cardiology, 118, (4) pp. 511-519. ISSN 0002-9149 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 Elsevier

DOI: doi:10.1016/j.amjcard.2016.05.041


Whether anxiety is a risk factor for a range of cardiovascular diseases is unclear. We aimed to determine the association between anxiety and a range of cardiovascular diseases. MEDLINE and EMBASE were searched for cohort studies that included participants with and without anxiety, including subjects with anxiety, worry, posttraumatic stress disorder, phobic anxiety, and panic disorder. We examined the association of anxiety with cardiovascular mortality, major cardiovascular events (defined as the composite of cardiovascular death, stroke, coronary heart disease, and heart failure), stroke, coronary heart disease, heart failure, and atrial fibrillation. We identified 46 cohort studies containing 2,017,276 participants and 222,253 subjects with anxiety. Anxiety was associated with a significantly elevated risk of cardiovascular mortality (relative risk [RR] 1.41, CI 1.13 to 1.76), coronary heart disease (RR 1.41, CI 1.23 to 1.61), stroke (RR 1.71, CI 1.18 to 2.50), and heart failure (RR 1.35, CI 1.11 to 1.64). Anxiety was not significantly associated with major cardiovascular events or atrial fibrillation although CIs were wide. Phobic anxiety was associated with a higher risk of coronary heart disease than other anxiety disorders, and posttraumatic stress disorder was associated with a higher risk of stroke. Results were broadly consistent in sensitivity analyses. Anxiety disorders are associated with an elevated risk of a range of different cardiovascular events, including stroke, coronary heart disease, heart failure, and cardiovascular death. Whether these associations are causal is unclear.

Item Details

Item Type:Refereed Article
Keywords:anxiety, cardiovascular
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Hunn, BHM (Dr Ben Hunn)
ID Code:110415
Year Published:2016
Web of Science® Times Cited:142
Deposited By:Medicine
Deposited On:2016-07-26
Last Modified:2022-08-25

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