Older Women Twice as Likely to Die in Five Years
After Having Panic Attack
Panic attack also makes them four times as likely to
suffer heart attack
Oct.
1, 2007 - Older women who experience at least one full-blown panic
attack may have an increased risk of having a heart attack or stroke and
an increased risk of death in the next five years, according to a report
in the October issue of Archives of General Psychiatry, one of the
JAMA/Archives journals.
Panic attacks involve the sudden development of
fear, anxiety or extreme discomfort accompanied by four or more
additional symptoms, according accepted definition. They may occur
sporadically or as part of an anxiety disorder, such as panic disorder,
social anxiety disorder or phobias.
Jordan W. Smoller, M.D., Sc.D., of Massachusetts
General Hospital, Boston, and colleagues studied 3,369 healthy
postmenopausal women (age 51 to 83, average age 65.9). When they entered
the study between 1997 and 2000, the women filled out a questionnaire
about the occurrence of panic attacks in the previous six months.
They were then followed for an average of 5.3 years
to see whether they had a heart attack or stroke or died from any cause.
About 10 percent of the women reported having a
full-blown panic attack in the six months prior to the study.
After the researchers adjusted for other
cardiovascular risk factors, having one or more panic attacks was
associated with four times the risk of myocardial infarction (heart
attack), three times the risk of having a heart attack or stroke and
nearly twice the risk of death from any cause.
These associations remained after controlling for
depression, suggesting that panic attacks may be a separate, independent
risk factor for cardiovascular events.
The results add panic attacks to the list of
emotions and psychiatric symptoms that have already been linked to
cardiovascular risk, including depression, anger and hostility, the
authors note.
Panic attacks could be associated with other
cardiovascular risk factors, such as hypertension. Alternatively,
anxiety could contribute to adverse cardiovascular effects, such as
coronary artery spasm, tendency toward increased blood clotting or
disturbances in heart rhythm.
"These results suggest that panic anxiety is a
marker for increased risk of cardiovascular morbidity and mortality
among postmenopausal women," the authors conclude.
"Future studies are needed to clarify the causal
connection, if any, between panic attacks and cardiovascular events. Our
results imply, however, that older women with a recent history of panic
attacks represent a subgroup at elevated risk of myocardial infarction
and stroke in whom careful monitoring and cardiovascular risk reduction
may be particularly important."
Editor's Note: The Women's Health Initiative
program is funded by the National Heart, Lung and Blood Institute, U.S.
Department of Health and Human Services. The Myocardial Ischemia and
Migraine Study was funded by Glaxo Wellcome (now GlaxoSmithKline).
