Anxiety and new onset of cardiovascular disease: critical review and meta-analysis. (March 2016)

• Record Type: Journal Article
• Authors: Batelaan, Neeltje M.; Seldenrijk, Adrie; Bot, Mariska; van Balkom, Anton J. L. M.; Penninx, Brenda W. J. H.
• Is Part Of: British journal of psychiatry. Volume 208:Number 3(2016)
• Page Start: 223
• Page End: 231
• Publication Date: 2016-03
• Subjects: Psychiatry -- Periodicals; Psychology, Pathological -- Periodicals; 616.89005
• DOI: 10.1192/bjp.bp.114.156554
• Languages: English
• ISSNs: 0007-1250

Abstract

Abstract : Background: Anxiety has been associated with new-onset cardiovascular disease (CVD), but the quality of this relationship is unclear. Only if anxiety is a causal, independent cardiovascular risk factor might it be a target for CVD prevention. Aims: To determine and examine the independent association and causality between anxiety and incident CVD. Method: PubMed, EMBASE and PsycINFO databases were searched up to October 2013. A review of Hill's criteria for causality and random effects meta-analysis were conducted of prospective, population-based studies examining anxiety and incident CVD in people free from CVD at baseline. Results: The meta-analysis comprised 37 papers ( n = 1 565 699). The follow-up ranged from 1 to 24 years. Anxiety was associated with a 52% increased incidence of CVD (hazard ratio = 1.52, 95% CI 1.36–1.71). The risk seemed independent of traditional risk factors and depression. The evaluation of Hill's criteria largely argued in favour of causality. Conclusions: Anxiety may be of interest for CVD prevention. Future research should examine biological and behavioural underpinnings of the association in order to identify targets for intervention.