Meta-Analysis of Anxiety as a Risk Factor for Cardiovascular Disease - 04/08/16
Abstract |
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.
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Dr. Emdin had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Emdin conceived of the study, acquired, analyzed and interpreted the data, and drafted and critically revised the report. Drs. Odutayo, Tran, Hunn, Hsiao, Wong acquired, analyzed and interpreted the data, and critically revised the report. |
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Drs. Emdin, Odutayo, Tran, and Hunn are supported by the Rhodes Trust, Oxford, United Kingdom. Dr. Wong is supported by the Rhodes Trust, Oxford, United Kingdom and by a Neil Hamilton Fairly Fellowship from the National Health and Medical Research Council, Canberra, Australia. Dr. Hsiao is supported by a National Science Foundation Graduate Research Fellowship. |
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No funders or sponsors were involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. |
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See page 518 for disclosure information. |
Vol 118 - N° 4
P. 511-519 - août 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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