Abstract
The aim of this paper is to summarise and evaluate the empirical support for the association between anxiety and cardiovascular disease (CVD) and to address challenges related to method and study design. We review results from meta-analyses and more recent findings on the association of anxiety and the risk of CVD. Depression and anxiety are often listed as psychosocial risk markers of CVD, but the role of anxiety as a risk factor for CVD has not received the same evidential support as the effects of depression. Through a narrative review we identified six meta-analyses as well as 15 recent large studies of anxiety and CVD that we summarise. Some of the conflicting findings may be artefacts of study design or population the sample is drawn from. Researchers should take care to be population specific, measurement specific and outcome specific, and to control for comorbid depression.
Highlights
MethodologyAnxiety disorders are the most prevalent group of psychiatric disorders worldwide (Pérez-Piñar et al, 2016) with a reported lifetime prevalence as high as almost 29% (Kessler et al, 2005)
As the differing practices observed in many studies pose a hindrance to further understanding of a potentially very relevant association, we make several suggestions that are aimed at helping to determine the real association between anxiety and Cardiovascular diseases (CVD): Firstly, there exists considerable variety regarding sample characteristics, with some samples consisting of participants free of CVD, while the majority of studies investigates either CVD-samples or those with risk factors for CVD
We have stated above the importance of any research on the association of anxiety with CVD to bear in mind the role of comorbid depression
Summary
MethodologyAnxiety disorders are the most prevalent group of psychiatric disorders worldwide (Pérez-Piñar et al, 2016) with a reported lifetime prevalence as high as almost 29% (Kessler et al, 2005). While research has mainly focused on depression, which is an obvious major psychiatric ailment, and has identified it as an independent risk factor for the development of CVD (Lichtman et al, 2014; Pan et al, 2011), the research on anxiety’s association with CVD has not yielded the same conclusive results so far. The aim of this narrative review article is to summarise recent findings and challenges in the research field.
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