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Phobic anxiety and increased risk of mortality in coronary heart disease

Lana L Watkins1, James A Blumenthal, Michael A Babyak

  • 1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. watki017@mc.duke.edu

Psychosomatic Medicine
|July 20, 2010
PubMed

Insights

Phobic anxiety increases cardiac mortality risk in women with coronary heart disease (CHD). This study found that reduced heart rate variability (HRV) did not mediate this risk in female patients.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Phobic anxiety may increase cardiac mortality risk in medically healthy individuals.
  • Established coronary heart disease (CHD) patients may also be at risk.
  • The role of heart rate variability (HRV) in this association is not fully understood.

Purpose of the Study:

  • To evaluate the association between phobic anxiety and cardiac mortality risk in patients with established CHD.
  • To investigate whether reduced HRV mediates this potential risk.
  • To examine gender differences in this association.

Main Methods:

  • Prospective cohort study of 947 CHD patients.
  • Baseline assessment included heart rate recordings for HRV and the Crown-Crisp phobic anxiety scale.
  • Fatal cardiac events were tracked for an average of 3 years.

Main Results:

  • Female CHD patients reported higher phobic anxiety levels than males.
  • Phobic anxiety showed a significant interaction with gender in predicting cardiac mortality and sudden cardiac death.
  • In women, phobic anxiety was associated with a 1.6-fold increased risk of cardiac mortality and a 2.0-fold increased risk of sudden cardiac death.
  • Phobic anxiety was not associated with increased mortality risk in men.
  • Reduced HRV was weakly associated with phobic anxiety in women but did not mediate the mortality risk.

Conclusions:

  • Phobic anxiety is prevalent in women with CHD and may be a significant risk factor for cardiac mortality.
  • Reduced resting HRV does not appear to mediate the increased cardiac mortality risk associated with phobic anxiety in women with CHD.
Abstract

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