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Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women.
Circulation 2005; 111(4):480-7Circ

Abstract

BACKGROUND

High levels of phobic anxiety have been associated with elevated risks of coronary heart disease (CHD) death and sudden cardiac death (SCD) among men. To the best of our knowledge, no studies have looked at this association among women. Anxiety may influence CHD mortality by increasing the risk of ventricular arrhythmia and SCD.

METHODS AND RESULTS

We prospectively examined the relationship between phobic anxiety, as measured by the Crown-Crisp index (CCI), and CHD among women participating in the Nurses' Health Study. Among 72,359 women with no history of cardiovascular disease or cancer in 1988, 97 SCDs, 267 CHD deaths, and 930 nonfatal myocardial infarctions (MI) were documented over 12 years of follow-up. A higher score on the CCI was associated with an increased risk of SCD and fatal CHD but not of nonfatal MI in age-adjusted (P, trend < or =0.008) and in multivariable models excluding possible biological intermediaries (P, trend < or =0.03). Multivariable adjustment appeared to attenuate the relations; women who scored 4 or greater on the CCI were at a 1.59-fold (95% CI, 0.97 to 2.60) marginally increased risk of SCD and a 1.31-fold (95% CI, 0.97 to 1.75) marginally increased risk of fatal CHD compared with those who scored 0 or 1. After control for possible intermediaries (hypertension, diabetes, and elevated cholesterol), a trend toward an increased risk persisted for SCD (P=0.06).

CONCLUSIONS

These prospective data suggest that high levels of phobic anxiety are associated with an increased risk of fatal CHD, particularly from SCD. Some but not all of this risk can be accounted for by CHD risk factors associated with phobic anxiety.

Authors+Show Affiliations

Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave East, Boston, MA 02215-1204, USA. calbert@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15687137

Citation

Albert, Christine M., et al. "Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women." Circulation, vol. 111, no. 4, 2005, pp. 480-7.
Albert CM, Chae CU, Rexrode KM, et al. Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation. 2005;111(4):480-7.
Albert, C. M., Chae, C. U., Rexrode, K. M., Manson, J. E., & Kawachi, I. (2005). Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation, 111(4), pp. 480-7.
Albert CM, et al. Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women. Circulation. 2005 Feb 1;111(4):480-7. PubMed PMID: 15687137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. AU - Albert,Christine M, AU - Chae,Claudia U, AU - Rexrode,Kathryn M, AU - Manson,JoAnn E, AU - Kawachi,Ichiro, PY - 2005/2/3/pubmed PY - 2005/7/12/medline PY - 2005/2/3/entrez SP - 480 EP - 7 JF - Circulation JO - Circulation VL - 111 IS - 4 N2 - BACKGROUND: High levels of phobic anxiety have been associated with elevated risks of coronary heart disease (CHD) death and sudden cardiac death (SCD) among men. To the best of our knowledge, no studies have looked at this association among women. Anxiety may influence CHD mortality by increasing the risk of ventricular arrhythmia and SCD. METHODS AND RESULTS: We prospectively examined the relationship between phobic anxiety, as measured by the Crown-Crisp index (CCI), and CHD among women participating in the Nurses' Health Study. Among 72,359 women with no history of cardiovascular disease or cancer in 1988, 97 SCDs, 267 CHD deaths, and 930 nonfatal myocardial infarctions (MI) were documented over 12 years of follow-up. A higher score on the CCI was associated with an increased risk of SCD and fatal CHD but not of nonfatal MI in age-adjusted (P, trend < or =0.008) and in multivariable models excluding possible biological intermediaries (P, trend < or =0.03). Multivariable adjustment appeared to attenuate the relations; women who scored 4 or greater on the CCI were at a 1.59-fold (95% CI, 0.97 to 2.60) marginally increased risk of SCD and a 1.31-fold (95% CI, 0.97 to 1.75) marginally increased risk of fatal CHD compared with those who scored 0 or 1. After control for possible intermediaries (hypertension, diabetes, and elevated cholesterol), a trend toward an increased risk persisted for SCD (P=0.06). CONCLUSIONS: These prospective data suggest that high levels of phobic anxiety are associated with an increased risk of fatal CHD, particularly from SCD. Some but not all of this risk can be accounted for by CHD risk factors associated with phobic anxiety. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15687137/Phobic_anxiety_and_risk_of_coronary_heart_disease_and_sudden_cardiac_death_among_women_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000153813.64165.5D?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -