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Anxiety disorder and cardiovascular disease: a two-sample Mendelian randomization study
Bo Peng1,2,3, Hong Meng1,2,3, Liang Guo1,2,3
1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Insights
Anxiety disorders causally increase the risk of coronary heart disease, myocardial infarction, and heart failure. This study found no link to atrial fibrillation, highlighting anxiety
Area of Science:
- Genetics
- Psychiatry
- Cardiology
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality.
- Anxiety disorders are prevalent psychiatric conditions linked to adverse cardiovascular outcomes.
Purpose of the Study:
- To investigate the causal relationship between anxiety disorders and major cardiovascular diseases using Mendelian randomization.
- Specifically examining coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF), and atrial fibrillation (AF).
Main Methods:
- A two-sample Mendelian randomization study utilizing large-scale genome-wide association study data.
- Genetic variants associated with anxiety disorders were identified from UK Biobank.
- Cardiovascular outcome data for CHD, MI, HF, and AF were sourced from the FinnGen study.
Main Results:
- Significant causal associations were found between anxiety disorders and increased risk of CHD, MI, and HF.
- No significant causal relationship was observed between anxiety disorders and AF.
- Robustness checks confirmed no evidence of reverse causality.
Conclusions:
- Anxiety disorders are causally linked to a higher risk of developing CHD, MI, and HF.
- The study did not find a causal link between anxiety disorders and AF in individuals of European descent.
- Further research is recommended to explore underlying mechanisms and diverse populations.
Aims:
Cardiovascular disease is the leading cause of death worldwide. Anxiety disorders are common psychiatric conditions associated with cardiovascular outcomes. This two-sample Mendelian randomization (MR) study investigated the causal relationship between anxiety disorders and coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF), and atrial fibrillation (AF).
Methods:
Single nucleotide polymorphisms (SNPs) associated with anxiety disorders (16 730 cases; 101 021 controls) were obtained from the UK Biobank genome-wide association study (GWAS). Cardiovascular outcome data were derived from the FinnGen study (CHD: 21 012 cases and 197 780 controls; MI: 12 801 cases and 187 840 controls; HF: 23 397 cases and 194 811 controls; and AF: 22 068 cases and 116 926 controls). Inverse variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode analyses examined causality.
Results:
IVW analysis demonstrated significant causal relationships between anxiety disorders and increased risk of CHD [odds ratio (OR): 4.496; 95% confidence interval (CI): 1.777-11.378; P = 0.002], MI (OR: 5.042; 95% CI: 1.451-17.518; P = 0.011), and HF (OR: 3.255; 95% CI: 1.461-7.252; P = 0.004). No relationship was observed with AF (OR: 1.775; 95% CI: 0.612-5.146; P = 0.29). Other methods showed non-significant associations. Two-way analysis indicated no reverse causality.
Conclusions:
Anxiety disorders were causally associated with greater risk of CHD, MI, and HF but not AF among individuals of European descent. Further research on mediating mechanisms and in diverse populations is warranted.
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