Tension, anxiety boost men’s heart disease, death risk

By Anne Harding

NEW YORK (Reuters Health) – Tension increases a man’s risk
of heart disease, heart rhythm abnormalities and death from any
cause, while women who report a high degree of anxiety are at
greater risk of death, a new study shows.

In fact, Dr. Elaine D. Eaker of Eaker Epidemiology
Enterprises in Chili, Wisconsin and colleagues note, tension
increases men’s death risk to the same degree that high blood
pressure does.

“The implication is you need to take care of the tension in
addition to taking care of your cholesterol and your diabetes,”
Eaker told Reuters Health. “This should be part and parcel of
the whole reduction and prevention of risk factors for heart
disease and mortality.”

The finding that tension and anxiety affected men and women
differently is nothing new, she added, although the reasons why
remain unclear.

Eaker and her team looked at 3,682 men and women
participating in the Framingham Offspring Study, whose average
age was 48.5 years, and followed them for 10 years.
Participants answered a brief series of yes-or-no questions to
evaluate their degree of tension and anxiety.

Men who reported higher-than-average levels of tension were
25% more likely to develop heart disease over the next 10
years, while their overall risk of death was 23% greater. They
were also 24% more likely to develop atrial fibrillation (AF),
a type of abnormal heart rhythm that can lead to stroke and
death.

For comparison, men with higher-than-average blood pressure
face a 23% increased 10-year risk of death.

Among women, there was no link between high levels of
tension and heart disease or mortality, but women with
higher-than-average levels of anxiety were 27% more likely to
die from any cause over the next 10 years.

While anxiety manifests itself in more physical ways, for
example with fatigue, dizziness and a pounding heart, tension
is characterized more by difficulty in relaxing, a sense of
restlessness and nervousness, and feelings of tension, Eaker
explained. The two are correlated, she added.

A number of studies have linked heart disease to
psychological factors, she added, but this is the first that
was able to control for other risk factors for heart disease,
such as cigarette smoking and being overweight, and the first
to investigate tension.

Past studies have also been limited because they have
relied on chest pain and other “soft” endpoints, which don’t
necessarily indicate heart disease, she added; however, this
study used “hard,” unambiguous endpoints like heart disease,
atrial fibrillation and death.

People who are concerned about their feelings of tension
and anxiety should see a health care provider, who can tell
them if seeking counseling might be appropriate, Eaker said.
Like weight loss or reducing one’s cholesterol, she added,
reducing tension and anxiety can be difficult for a person to
do without some professional help. “I don’t think it’s a good
idea for people to sort of self-diagnose,” she said.

SOURCE: Psychosomatic Medicine, September-October 2005.