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Does anxiety increase your risk for heart disease?

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By Ross Walker

There are five major categories of risk factors for heart disease:

1) Hypertension 

2) Genetic, metabolic and dietary fat/cholesterol issues 

3) Diabetes and metabolic syndrome 

4) Cigarette smoking 

5) Family history of vascular disease before age 60 

One, or a combination of any of these factors, is the major reason people develop fat build up in the wall their arteries, also known as atherosclerosis. 

But what puts the fat there in the first place has nothing to do with what makes a stable fatty plaque rupture. 

There are five major categories of the precipitation of plaque rupture:

1) Psychosocial factors

2) Infection

3) Extremes of exercise

4) Dietary excesses 

5) Bad life behaviour 

Let's focus on psychosocial factors, and in particular, anxiety. Around 20% of the population suffer some form of anxiety. Recent studies have shown that anxiety increases heart disease risk by a factor of eight times. Closely linked to this is depression, which is also associated with an increased risk for heart disease. A recent meta-analysis showed that anxious people have a 48% increased risk for a heart problem. It therefore appears that health anxiety is a self-fulfilling prophecy. 

Health anxiety is defined as excess worrying over serious illness, seeking medical advice at an excessive level despite the absence of any obvious physical disease.

People with health anxiety often misread physical symptoms as serious illnesses and they seek repeated medical assessments for the same issues. This is also called, of course, hypochondria. As I have mentioned previously, my daughter, Bridget, bought me a cup that I have in my medical clinic that says, “Please do not confuse your Google search with my medical degree”. 

A new study from the British Medical Journal-Open, looked at just over 7000 patients for 12 years who were born between 1953 to 1957. They had standard physical measures such as pulse rate, BP and weight, along with routine blood tests. They also reported their anxiety levels via the Whiteley index. Scores greater than 90% were deemed as anxiety levels. Over this 12-year period, 234 patients or 3.2% experienced a heart attack or angina. Health anxiety doubled the rate of heart disease, or in other words, increased heart disease risk by 73%. The absolute figures were a 6.1% risk of heart disease in those with health anxiety, compared with only 3% in those who did not exhibit this trait. 

It is an interesting phenomenon that people who are very concerned about their health and often attend doctors with large folders of health monitoring and their own health records, recording every single health parameter they possibly can, falsely believe that this form of taking control of their health will reduce their risk for disease.

This study, and a number of others, actually suggest it is the complete opposite. 

It appears that anxiety begets anxiety and subsequently anxiety begets heart disease. It appears that it's much better to smell the roses then to analyse them. It is situations like this where the wonderful parable of the little boy who cried wolf comes to mind. 

Maybe the epitaph on the hypochondriac's grave says it all: It says, I told you so.

Published: Thursday, December 08, 2016


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