Prospective Examination of Anxiety Persistence and Its Relationship to Cardiac Symptoms and Recurrent Cardiac Events

Vol. 73, No. 6, 2004

Free Abstract Article (Fulltext) Article (PDF 106 KB)

Regular Article

Prospective Examination of Anxiety Persistence and Its Relationship to Cardiac Symptoms and Recurrent Cardiac Events
Sherry L. Grace^a, Susan E. Abbey^a,b, Jane Irvine^a,c, Zachary M. Shnek^b,d, Donna E. Stewart^a,b

^aUniversity Health Network Women's Health Program,
^bDepartment of Psychiatry, University of Toronto,
^cYork University, Toronto, and
^dCredit Valley Hospital, Mississauga, Canada

Address of Corresponding Author

Psychother Psychosom 2004;73:344-352 (DOI: 10.1159/000080387)

Key Words

Phobic anxiety
Panic
Cardiac symptoms
Myocardial infarction
Unstable angina
Healthcare utilization

Abstract

Background: The current study builds on previous research demonstrating a link between anxiety and inhospital recurrent ischemic and arrhythmic events, by examining the effects of persistent anxiety on recurrent events 1 year later. Methods: 913 patients with unstable angina (UA) and myocardial infarction (MI) from 12 coronary care units were recruited, and follow-up data were collected at 6 and 12 months after the event. Measures included cardiac symptomatology, healthcare utilization, the anxiety subscale of the Primary Care Evaluation of Mental Disorders , the phobic anxiety subscale of the Middlesex Hospital Questionnaire, and the Beck Depression Inventory. Results: Over one third of participants with UA and MI experienced elevated anxiety at the time of the ischemic event, and these symptoms persisted for 1 year in 50% of anxious participants. Although participants with anxiety reported more atypical cardiac symptomatology, the prevalence of typical cardiac symptoms such as chest pain did not differ based on anxiety. After controlling for the severity of the coronary event, family income, sex, diabetes, and smoking, the following variables were significantly predictive of self-reported recurrent cardiac events at 6 months or 1 year: older age, family history of cardiovascular disease, greater depressive symptomatology at baseline, and anxiety at 6 months. Only 38% of anxious patients were asked about such symptoms, indicating underutilization of effective psychotherapeutic treatment. Conclusions: Over and above the effects of depressive symptomatology (among other confounding variables), nonphobic anxiety appears to have a negative effect on self-reported outcome following an ischemic coronary event. Anxiety symptomatology is underrecognized and undertreated, and examination of effects of treatment on secondary prevention must be pursued.

Author Contacts

Sherry L. Grace, PhD
University Health Network Women's Health Program
ML2-004C, 657 University Avenue
Toronto, Ont., M5G 2N2 (Canada)
Tel. +1 416 340 4800, ext. 6455, Fax +1 416 340 4185, E-Mail sherry.grace@uhn.on.ca

Article Information

Number of Print Pages : 9
Number of Figures : 0, Number of Tables : 7, Number of References : 52

Medline Abstract (ID 15479989)

Download Citation

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.