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. 2021 Feb;36(2):148-163.
doi: 10.1080/08870446.2020.1779273. Epub 2020 Jun 25.

Anxiety as a risk factor for cardiovascular disease independent of depression: a prospective examination of community-dwelling men (the MrOS study)

Håvard R Karlsen  1 , Ingvild Saksvik-Lehouillier  1 , Katie L Stone  2 , Eva Schernhammer  3   4   5 , Kristine Yaffe  6   7   8   9 , Eva Langvik  1
Affiliations

Anxiety as a risk factor for cardiovascular disease independent of depression: a prospective examination of community-dwelling men (the MrOS study)

Håvard R Karlsen et al. Psychol Health. 2021 Feb.

Abstract

Anxiety and depression have been linked to increased risk of cardiovascular disease (CVD). Whether anxiety is a risk factor independent from depression, and if associations are limited to specific CVD outcomes remains unclear. Design: Participants (N = 3135) of the prospective Osteoporotic Fracturs in Men Sleep ancillary study were community-dwelling men (age ≥ 65) living in the US. Main outcome measures: The Goldberg Anxiety and Depression Scales, coronary heart disease (CHD) and cerebrovascular disease (CER). We used Cox proportional hazards models to calculate adjusted hazard ratios and 95% confidence intervals. Results: During 12 years of follow-up, we accrued 612 cases of CHD and 291 cases of CER (incident or repeat-event). Overall, we observed no association between anxiety or depression and CER. Anxiety was significantly associated with CHD, but this effect was attenuated after controlling for depression and covariates. Depression was significantly associated with CHD after similar adjustments. For men without prior history of CVD, neither anxiety nor depression were associated with incident CHD. Conclusions: Anxiety was not a significant independent predictor of CHD or CER, suggesting that previous findings of anxiety as a risk factor of CVD might be attributed to failure to control for the effect of depression.

Keywords: Anxiety; cardiovascular disease; coronary heart disease; depression; elderly; stroke.

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Conflict of interest statement

Declarations of interest

Dr Stone reports grants from NIH, during the conduct of the study. The other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Flow diagram of participant recruitment.
Figure 2
Figure 2
Anxiety and risk of CHD in total sample.
Figure 3
Figure 3
Anxiety and risk of CHD in sample with no previous diagnosis of CVD.
Figure 4
Figure 4
Anxiety and risk of CHD in sample with prior history of CVD.
See this image and copyright information in PMC

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References

    1. Albus C (2010). Psychological and social factors in coronary heart disease. Annals of Medicine, 42(7), 487–494. 10.3109/07853890.2010.515605 - DOI - PubMed
    1. Alvarenga ME, & Byrne D (2016). Anxiety and Cardiovascular Disease: Epidemiology and Proposed Mechanisms In Alvarenga ME & Byrne D (Eds.), Handbook of Psychocardiology (pp. 247–263). Springer; Singapore: 10.1007/978-981-287-206-7_10 - DOI
    1. Bandelow B, & Michaelis S (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335. - PMC - PubMed
    1. Batelaan NM, Seldenrijk A, Bot M, Van Balkom AJLM, & Penninx BWJH (2016). Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. British Journal of Psychiatry, 208(3), 223–231. 10.1192/bjp.bp.114.156554 - DOI - PubMed
    1. Benyamini Y, Roziner I, Goldbourt U, Drory Y, & Gerber Y (2013). Depression and anxiety following myocardial infarction and their inverse associations with future health behaviors and quality of life. Annals of Behavioral Medicine, 46(3), 310–321. 10.1007/s12160-013-9509-3 - DOI - PubMed

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