Can Anxiety Cause a Heart Attack?

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A number of studies link depression with heart attacks, although doctors aren't sure how depression increases the risk. But what about anxiety? A reader asks: “I know that depression is a risk factor for a heart attack. But what about anxiety?”

Anxiety also appears to be a risk factor for heart attacks. According to a recent study of 735 older, healthy men, published in the Journal of the American College of Cardiology, those with the highest levels of anxiety were at greater risk for a heart attack over 12 years than men with less anxiety. In addition, the more severe the anxiety, the higher the risk of a heart attack.

The relationship between anxiety and heart attacks held even after controlling for other heart attack risk factors -- such as age, body weight, LDL cholesterol levels, and systolic blood pressure -- and after taking into account other negative emotions like depression and anger. In fact, anxiety was a better predictor of heart attacks than depression, anger, hostility, and type A behavior.

Anxious people experience chronic stress, which activates the autonomic nervous system and may increase inflammation and blood clotting, all of which can contribute to heart attacks. Anxiety may also impair regulation of heart rate. Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety, phobias, and generalized anxiety disorder.

All of these illnesses are treatable. If you think you may have an anxiety disorder, call your doctor. Treatment options include cognitive-behavioral therapy, relaxation techniques, and medication.