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. 2024 Jun 14;24(1):443.
doi: 10.1186/s12888-024-05798-w.

Anxiety, a significant risk factor for coronary artery disease: what is the best index

Mojtaba Rezaee #  1 , Haniyeh Darroudi #  2 , Leila Etemad #  3   4 , Arya Nasimi Shad  5 , Zahra Zardast  6 , Houra Kohansal  7 , Majid Ghayour-Mobarhan  8   9 , Fatemeh Sadeghian  10 , Mohsen Moohebati  11 , Habibollah Esmaily  12   13 , Susan Darroudi  14   15 , Gordon A Ferns  16
Affiliations

Anxiety, a significant risk factor for coronary artery disease: what is the best index

Mojtaba Rezaee et al. BMC Psychiatry. .

Abstract

Background: Coronary artery disease (CAD) is known as the leading cause of disability and death globally. Anxiety disorders are also recognized as common types of mental disorders that substantially impact global health. Iran ranks among the countries with a high incidence of CAD and anxiety disorders. Therefore, the present study aims to determine the potential association and epidemiological aspects of anxiety and CAD within the population of Mashhad, the second most popoulos city in Iran.

Methods: The present study is based on extracted data from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study which is a 10-year prospective cohort study intended to assess the effects of various CAD risk factors among Mashhad city residents. Anxiety scores were assessed at the baseline using Beck Anxiety Inventory and individuals were classified based on the BAI 4-factor structure model which included autonomic, cognitive, panic, and neuromotor components. Accordingly, the association between baseline anxiety scores and the BAI four-factor model with the risk of CAD events was analyzed using SPSS software version 21.

Results: Based on the results, 60.4% of the sample were female, and 5.6% were classified as having severe forms of anxiety. Moreover, severe anxiety was more prevalent in females. Results showed a 1.7% risk of CAD (p-value < 0.001) over 10 years with one unit increase in anxiety score. Based on the 4-factor model structure, we found that only panic disorder could significantly increase the risk of CAD by 1.1% over the 10-year follow-up (p-value < 0.001).

Conclusion: Anxiety symptoms, particularly panic disorder, are independently and significantly associated with an increased overall risk of developing CAD over a 10-year period. Therefore, further studies are warranted to investigate the mechanisms through which anxiety may cause CAD, as well as possible interventions to mitigate these processes.

Keywords: Anxiety; Beck anxiety inventory; Coronary artery diseases; Factor structure model; Panic disorder.

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Conflict of interest statement

The Authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of study subjects
Fig. 2
Fig. 2
Mean of anxiety total score and factor models of BAI items in MASHAD cohort study according to the CAD event after 10 years follow-up; ***p < 0.001
Fig. 3
Fig. 3
Relative risk of CAD event according to anxiety total score and factor models of BAI items in MASHAD study at baseline; sex, age, marriage status, job status, education level, smoking status, obesity, diabetes. ***p < 0.001
Fig. 4
Fig. 4
Summary of result
See this image and copyright information in PMC

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