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Anxiety and Cardiovascular Disease: Epidemiology and Proposed Mechanisms

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Handbook of Psychocardiology

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Abstract

Anxiety disorders tend to be highly prevalent in heart disease, particularly amongst patients recovering from acute cardiac events. Yet, the role of anxiety in heart disease has not received as much attention in the literature as has depression. Epidemiologic studies indicate that there is an increased risk of sudden death and myocardial infarction in patients experiencing panic anxiety. Pathophysiologic correlates of anxiety appear to contribute to an increased cardiac risk, leading to the appreciation that anxiety disorders might in fact constitute a risk to life as exemplified by the cardiovascular disease link. Explanatory mechanisms of cardiac risk point to a link between anxiety and heart disease being mediated by stress giving way to increased cardiac sensitivity and reactivity.

The present chapter reviews the psychobiological link between anxiety and heart disease. It also supports an integrative approach for the analysis of psychogenic heart disease, that cardiac patients can benefit from cardiologists educating them about the influence of psychosocial factors on their cardiac conditions and that further research is required on the development of specific psychologically based therapies which tap into the proposed pathophysiological mechanisms associated with the mind-heart nexus.

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References

  • AHF. (2014). Heart disease and stroke statistics – 2014 update: A report from the American Heart Association. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Dallas, Texas, United States.

    Google Scholar 

  • Ahn, J. H., Park, S. H., Shin, W. Y., & Lee, H. M. J. Y. (2011). Long QT syndrome and Torsade de Pointes associated with Takotsubo cardiomyopathy. Journal of Korean Medical Sciences., 26, 959–961.

    Article  Google Scholar 

  • Albert, C. M., Chae, C. U., Rexrode, K. M., Manson, J. E., & Kawachi, I. (2005). Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation, 111, 480–487.

    Article  PubMed  Google Scholar 

  • Alvarenga, M. E., Richards, J. C., Lambert, G., & Esler, M. D. (2006). Psychophysiological mechanisms in panic disorder: A correlative analysis of noradrenaline spillover, neuronal noradrenaline reuptake, power spectral analysis of heart rate variability and psychological variables. Psychosomatic Medicine, 68, 8–16.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association (text rev.).

    Google Scholar 

  • Asmundson, G. J., Sandler, L. S., Wilson, K. G., & Norton, G. R. (1993). Panic attacks and interoceptive acuity for cardiac sensations. Behaviour Research and Therapy, 31(2), 193–197.

    Article  PubMed  Google Scholar 

  • Atiga, W. L., Calkins, H., Lawrence, J. H., Tomaselli, G. F., Smith, J. M., & Berger, R. D. (1998). Beat-to-beat repolarization lability identifies patients at risk for sudden cardiac death. Journal of Cardiovascular Electrophysiology, 9, 899–908.

    Article  PubMed  Google Scholar 

  • Atiga, W. L., Fananapazir, L., McAreavey, D., Calkins, H., & Berger, R. D. (2000). Temporal repolarization lability in hypertrophic cardiomyopathy caused by β-myosin heavy-chain gene mutations. Circulation, 101, 1237–1242.

    Article  PubMed  Google Scholar 

  • Barlow, D. H. (2002). Anxiety and its disorders. The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Batelaan, N. M., ten Have, M., van Balkom, A. J. L. M., Tuithof, M., & de Graff, R. (2014). Anxiety disorders and onset of cardiovascular disease: The differential impact of panic, phobias and worry. Journal of Anxiety Disorders, 28, 252–258.

    Article  PubMed  Google Scholar 

  • Berger, R. D., Kasper, E. K., Baughman, K. L., Marban, E., Calkins, H., & Tomaselli, G. F. (1997). Beat to beat QT internal variability: Novel evidence for repolarization lability in ischemic and nonischemic dilated cardiomyopathy. Circulation, 96, 1557–1565.

    Article  PubMed  Google Scholar 

  • Bers, D. M. (2002). Cardiac excitation contraction coupling. Nature, 415, 198–205.

    Article  PubMed  Google Scholar 

  • Bigger, J. T., Fleiss, J. L., Steinman, R. C., Rolnitzky, L. M., Kleiger, R. E., & Rottman, J. N. (1992). Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation, 85(1), 164–171.

    Article  PubMed  Google Scholar 

  • Black, P. H., & Garbutt, L. D. (2002). Stress, inflammation and cardiovascular disease. Journal of Psychosomatic Research, 52(1), 1–23.

    Article  PubMed  Google Scholar 

  • Brennan, A. M., Fargnolli, J. L., Li, T., Williams, C. J., Willett, W., Kawachi, I., Qi, L., Hu, F. B., & Mantzoros, C. S. (2009). Phobic anxiety is associated with higher serum concentrations of adipokines and cytokines in women with diabetes. Diabetes Care, 32(5), 926–931.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brosschot, J. F., Van Dijk, E. & Thayer, J. F. (2007). Daily worry is related to low heart rate variability during waking and the subsequent nocturnal sleep period. International Journal of Psychophysiology 63, 39–47.

    Google Scholar 

  • Brunner, L. S., Suddarth, D. S., & O’Connell Smeltzer, S. C. (2004). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  • Bunker, S. J., Colquhoun, D. M., Esler, M. D., Hickie, I. B., Hunt, D., Jelinek, V. W., Oldenburg, B. F., Peach, H. G., Ruth, D., Tennant, C. C., & Tonkin, A. M. (2003). “Stress” and coronary heart disease: Psychosocial risk factors. Medical Journal of Australia, 178(6), 272–276.

    PubMed  Google Scholar 

  • Cameron, O. G. (2007). Understanding comorbid depression and anxiety. Psychiatric Times, 24(14), 51–56.

    Google Scholar 

  • Chiou, A., Potempa, K., & Buschmann, M. B. (1997). Anxiety, depression and coping methods of hospitalized patients with myocardial infarction in Taiwan. International Journal of Nursing Studies, 34(4), 305–311.

    Article  PubMed  Google Scholar 

  • Coryell, W., Noyes, R., & House, D. (1986). Mortality among outpatients with anxiety disorders. American Journal of Psychiatry, 143(4), 508–510.

    Article  PubMed  Google Scholar 

  • Coughlin, S. S. (2011). Posttraumatic stress disorder and cardiovascular disease. The Open Cardiovascular Medicine Journal, 5, 164–179.

    Article  PubMed Central  PubMed  Google Scholar 

  • Crotti, L., Celano, G., Dagradi, F., & Schwartz, P. J. (2008). Congenital long QT syndrome. Orphanet Journal of Rare Diseases, 3, 18.

    Article  PubMed Central  PubMed  Google Scholar 

  • Da Costa, J. M. (1871). Art. 1. On irritable heart; a clinical study of a form of functional cardiac disorder and its consequences. American Journal of Medical Sciences, 121(1), 2–52.

    Article  Google Scholar 

  • Daly, J., Sindone, A. P., Thompson, D. R., Hancock, K., Chang, E., & Davidson, P. (2002). Barriers to participation in and adherence to cardiac rehabilitation programs: A critical literature review. Progress in Cardiovascular Nursing, 17(1), 8–17.

    Article  PubMed  Google Scholar 

  • Delmas, C., Lairez, O., Mulin, E., Delmas, T., Boudou, N., Dumonteil, N., Biendel-Picquet, C., Roncalli, J., Elbaz, M., Galinier, M., & Carrie, D. (2013). Anxiodepressive disorders and chronic psychological stress are associated with Tako-Tsubo cardiomyopathy- new physiopathological hypothesis. Circulation Journal, 77(1), 175–180.

    Article  PubMed  Google Scholar 

  • Descartes, R. (1649). Le Passiones de L’Alme (passions of the soul) (trans: Voss, S. H.). Indianapolis: Hackett, 1989.

    Google Scholar 

  • El-Gabalawy, R., Mackenzie, C. S., Thibodeau, M. A., Asmund, G. L., & Sareen, J. (2013). Health anxiety disorders in older adults: Conceptualizing complex conditions in late life. Clinical Psychology Review, 33(8), 1096–1105.

    Article  PubMed  Google Scholar 

  • Esler, M. D. (1998). Mental stress, panic disorder and the heart. Stress Medicine, 14, 237–243.

    Article  Google Scholar 

  • Esler, M. (2000). The sympathetic system and hypertension. American Journal of Hypertension, 13(2), 99S–105S.

    Article  PubMed  Google Scholar 

  • Esler, M., Alvarenga, M., Kaye, D., Lambert, G., Thompson, J., Hastings, J., Schwarz, R., Morris, M., & Richards, J. (2004a). Panic disorder. In D. Robertson, P. A. Low, G. Burnstock, & I. Biaggioni (Eds.), Primer of the autonomic nervous system. Amsterdam: Elsevier.

    Google Scholar 

  • Esler, M., Alvarenga, M., Lambert, G., Kaye, D., Hastings, J., Jennings, G., Morris, M., Schwarz, R., & Richards, J. (2004b). Cardiac sympathetic nerve biology and brain monoamine turnover in panic disorder. Annals of the New York Academy of Science, 1018, 505–514.

    Article  Google Scholar 

  • Esler, M., Alvarenga, M., Pier, C., Richards, J., El-Osta, A., Barton, D., Haikerwal, D., Kaye, D., Schlaich, M., Guo, L., Jennings, G., Socratous, F., & Lambert, G. (2006). The neuronal noradrenaline transporter, anxiety and cardiovascular disease. Journal of Psychopharmacology, 20(4), 60–66.

    Article  PubMed  Google Scholar 

  • Esler, M., Schwarz, R., & Alvarenga, M. (2008). Mental stress is a cause of cardiovascular diseases: From scepticism to certainty. Stress and Health, 24, 175–180.

    Article  Google Scholar 

  • Fleet, R., Lavoie, K., & Beitman, B. D. (2000). Is panic disorder associated with coronary artery disease? A critical review of the literature. Journal of Psychosomatic Research, 48, 347–356.

    Article  PubMed  Google Scholar 

  • Fox, K., Ford, I., Steg, P. G., Tendera, M., Robertson, M., & Ferrari, R. (2008). Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): A subgroup analysis of a randomised controlled trial. Lancet, 6372(9641), 817–821.

    Article  Google Scholar 

  • Frasure-Smith, N., Lesperance, F., & Talajic, M. (1995). The impact of negative emotions on prognosis following myocardial infarction: Is it more than depression? Health Psychology, 14(5), 388–398.

    Article  PubMed  Google Scholar 

  • Friedman, S. (2000). Cardiac disease, anxiety and sexual functioning. American Journal of Cardiology, 86(2 Suppl 1), 46–50.

    Article  Google Scholar 

  • Gold, L. S., Kane, L. B., Sotoodehnia, N., & Rea, T. (2007). Disaster events and the risk of sudden cardiac death: A Washington State investigation. Prehospital Disaster Medicine, 22(4), 313–317.

    PubMed  Google Scholar 

  • Goldstein, D. S., Robertson, D., Esler, M. D., Straus, S., & Eisenhofer, G. (2002). Dysautonomias: Clinical disorders of the autonomic nervous system. Annals of Internal Medicine, 137(9), 753–763.

    Article  PubMed  Google Scholar 

  • Gomez-Caminero, A., Blumentals, W. A., Russo, L. J., Brown, R. R., & Castilla-Puentes, R. (2005). Does panic disorder increase the risk of coronary heart disease? A cohort study of a national managed care database. Psychosomatic Medicine, 67(5), 688–691.

    Article  PubMed  Google Scholar 

  • Grace, S. L., Abbey, S. E., Irvine, J., Shnek, Z. M., & Stewart, D. E. (2004). Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events. Psychotherapy and Psychosomatics, 73(6), 344–352.

    Article  PubMed  Google Scholar 

  • Graham, H. (2003). A conceptual map for studying long-term exercise in a cardiac population. Rehabilitation Nursing, 28(3), 80–86.

    Article  PubMed  Google Scholar 

  • Haines, A. P., Imeson, J. D., & Mease, T. W. (1987). Phobic anxiety and ischaemic heart disease. British Medical Journal, 295, 297–299.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hammel, J. C., Smitherman, T. A., McGlynn, D., Mulfinger, A. M. M., Lazarte, A., & Gothard, K. D. (2011). Vagal influence during worry and cognitive challenge. Anxiety, Stress and Coping: An International Journal, 24(2), 121–136.

    Article  Google Scholar 

  • Heidenreich, W. F. (2003). Assessment for congenital long QT syndrome. Journal of Insur Med, 35(3–4), 196–200.

    Google Scholar 

  • Heikkila, J., Paunonen, M., Laippala, P., & Virtanen, V. (1998). Nurses’ ability to perceive patients’ fears related to coronary arteriography. Journal of Advanced Nursing, 28(6), 1225–1235.

    Article  PubMed  Google Scholar 

  • Herrmann, C., Brand-Driehorst, S., Buss, U., & Rüger, U. (2000). Effects of anxiety and depression on 5-year mortality in 5057 patients referred for exercise testing. Journal of Psychosomatic Research, 48(4–5), 455–462.

    Article  PubMed  Google Scholar 

  • James, W. (1892). The stream of consciousness (Psychology). Cleveland/New York: H.Holt, Chapter XI.

    Google Scholar 

  • Janszky, I. S., Ahnve, S., Lundber, I., & Hemmingsson, T. (2010). Early onset depression, anxiety, and risk of subsequent coronary heart disease: 37 year follow up of 49,321 young Swedish Men. Journal of American Cardiology, 56(1), 31–37.

    Article  Google Scholar 

  • Kalisch, R., Wiech, K., Critchley, H. D., Seymour, B., O’Doherty, J. P., Oakley, D. A., Allen, P., & Dolan, R. J. (2005). Anxiety reduction through detachment: Subjective, physiological, and neural effects. Journal of Cognitive Neuroscience, 17(6), 874–883.

    Article  PubMed  Google Scholar 

  • Kannel, W. B., Cupples, L. A., & D’Agostino, R. B. (1987). Sudden death risk in overt coronary heart disease: The Framingham study. American Heart Journal, 113(3), 799–804.

    Article  PubMed  Google Scholar 

  • Kawachi, I., Sparrow, D., Vokonas, P. S., & Weiss, S. T. (1994). Symptoms of anxiety and risk of coronary heart disease: The normative aging study. Circulation, 90, 2225–2229.

    Article  PubMed  Google Scholar 

  • Kawachi, I., Colditz, G. A., Ascherio, A., Rimm, E. B., Giovannucci, E., Stampfer, M. J., & Willett, W. C. (1996). A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. Journal of Epidemiology & Community Health, 50(3), 245–5.

    Article  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, R., & Walters, E. E. (2005). Lifetime prevalence of age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  PubMed  Google Scholar 

  • Khoury, N., Marvar, P. J., Gillespie, C. F., Wingo, A., Schwartz, A., Bradley, B., Kramer, M., & Ressler, K. J. (2012). The renin-angiotensin pathway in PTSD: ACE inhibitor and ARB medications are associated with fewer traumatic stress symptoms. Journal of Clinical Psychiatry, 73(6), 849–855.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kircanski, K., Craske, M. G., Epstein, A. M., & Wittchen, H. U. (2009). Subtypes of panic attacks: A critical review of the empirical literature. Depression and Anxiety, 26, 878–887.

    Article  PubMed  Google Scholar 

  • Kolloch, R., Legler, U. F., Champion, A., Cooper-Dehoff, R. M., Handberg, E., et al. (2008). Impact of resting heart rate on outcomes in hypertensive patients with coronary artery disease: Findings from the INternational VErapamil-SR/trandolapril STudy (INVEST). European Heart Journal, 29, 1327–1334.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kotseva, K., Wood, D., De Backer, G., De Bacquer, D., Pyörälä, K., & Keil, U. (2009). Cardiovascular prevention guidelines in daily practice: A comparison of EUROASPIRE I, II and III surveys in eight European countries. The Lancet, 373(9667), 929–940.

    Article  Google Scholar 

  • Kubzansky, L. D., & Arthur, C. M. (2004). Anxiety, heart disease and mortality. In N. Anderson (Ed.), Emotional longevity. New York: Viking.

    Google Scholar 

  • Kubzansky, L. D., Kawachi, I., Spiro, A., III, Weiss, S. T., Vokonas, P. T., & Sparrow, D. (1997). Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the normative aging study. Circulation, 95(4), 818–824.

    Article  PubMed  Google Scholar 

  • Lambert, E., Hotchkin, E., Alvarenga, M., Pier, C., Richards, J., Barton, D., Dawood, T., Esler, M., & Lambert, G. (2006). Single-unit analysis of sympathetic nervous discharges in patients with panic disorder. Journal of Physiology, 570(3), 637–643.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lane, D., Carroll, D., Ring, C., Beevers, D. G., & Lip, G. Y. (2001). Predictors of attendance at cardiac rehabilitation after myocardial infarction. Journal of Psychosomatic Research, 51, 497–501.

    Article  PubMed  Google Scholar 

  • Lane, R. D., Laukes, C., Marcus, F. I., et al. (2005). Psychological stress preceding idiopathic ventricular fibrillation. Psychosomatic Medicine, 67, 359–365.

    Article  PubMed  Google Scholar 

  • Leor, J., Poole, W. K., & Kloner, R. A. (1996). Sudden cardiac death triggered by an earthquake. The New England Journal of Medicine, 334, 413–419.

    Article  PubMed  Google Scholar 

  • Malik, M., & Camm, A. J. (1990). Heart rate variability. Clinical Cardiology, 13, 570–576.

    Article  PubMed  Google Scholar 

  • Malliani, A., Pagani, M., Lombardi, E., & Cerruti, S. (1991). Cardiovascular neural regulation explored in the frequency domain. Circulation, 84, 482–492.

    Article  PubMed  Google Scholar 

  • Mansour, V. M., Wilkinson, D. J. C., Jennings, G. L., Schwarz, R. G., Thompson, J. M., & Esler, M. D. (1998). Panic disorder: Coronary spasm as a basis for cardiac risk? MJA, 168, 390–392.

    PubMed  Google Scholar 

  • Martens, E., De Jonge, P., Na, B., Cohen, B., Lett, H., & Whooley, M. (2010). Scared to death? Generalised anxiety disorder and cardiovascular events in patients with stable coronary heart disease. Archives of General Psychiatry, 67(7), 750–758.

    Article  PubMed  Google Scholar 

  • Mathers, C. D., & Loncar, D. (2006). Updated projections of global mortality and burden of disease, 2002–2030: Data sources, methods and results. PLoS Med, 3(11):e442. Text available at http://www.who.int/healthinfo/statistics/bod_projections2030_paper.pdf

  • Matthews, K. A., Owens, J. F., Kuller, L. H., Sutton-Tyrrell, Lasilla, H. C., & Wolfson, S. K. (1998). Stress-induced pulse pressure changes predicts women’s carotid atherosclerosis. Stroke, 29, 1525–1530.

    Article  PubMed  Google Scholar 

  • Mayou, R. A., Gill, D., Thompson, D. R., et al. (2000). Depression and anxiety as predictors of outcome after myocardial infarction. Psychosomatic Medicine, 62(2), 212–219.

    Article  PubMed  Google Scholar 

  • McGrady, A., McGinnis, R., Badenhop, D., Bentle, M., & Rajput, M. (2009). Effects of depression and anxiety on adherence to cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation & Prevention., 29(6), 358–364.

    Article  Google Scholar 

  • Meisel, S. R., Kutz, I., Dayan, K. I., Pauzner, H., Chetboun, I., Arbel, Y., & David, D. (1991). Effect of Iraqi missile war on incidence of acute myocardial infarction and sudden death in Israeli civilians. Lancet, 338(8768), 660–661.

    Article  PubMed  Google Scholar 

  • Mendenhall, M. E., Osland, J. S., Bird, A., Oddou, G. R., & Maznevski, M. L. (2008). Global leadership: Research, practice, and development. London: Routledge.

    Google Scholar 

  • Molgaard, H., Sorensen, K. E., & Bjerregaard, P. (1991). Attenuated 24-h heart rate variability in apparently healthy subjects, subsequently suffering sudden cardiac death. Clinical Autonomic Research, 1, 233–237.

    Article  PubMed  Google Scholar 

  • Moser, D. K., & De Jong, M. J. (2006). Anxiety and heart disease. In E. Mollinari, A. Compare, & G. Paratti (Eds.), Clinical psychology and heart disease. Italia: Springer.

    Google Scholar 

  • Moser, D. K., & Dracup, K. (1996). Is anxiety early after myocardial infarction associated with subsequent ischemic and arrhythmic events? Psychosomatic Medicine, 58, 395–401.

    Article  PubMed  Google Scholar 

  • Mosovich, S. A., Boone, R. T., Reichenberg, A., Bansilal, S., Shaffer, J., Dahlman, K., Harvey, P. D., & Farkouh, M. E. (2008). New insights into the link between cardiovascular disease and depression. International Journal of Clinical Practice, 62, 423–432.

    Article  PubMed  Google Scholar 

  • Nesbitt, W. S., Giuliano, S., Kulkarni, S., Dopheide, S. M., Harper, I. S., & Jackson, S. P. (2003). Intercellular calcium communication. The Journal of Cell Biology, 160(7), 1151–1161.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pajak, A., Jankowski, P., Kotseva, K., Heidrich, J., De Smedt, D., & De Bacquer, D. (2013). Depression, anxiety and risk factor control in patients after hospitalisation for coronary heart disease: The EUROASPIRE III study. European Journal of Cardiology, 20(2), 331–340.

    Article  Google Scholar 

  • Paterniti, S., Zureik, M., Ducimetière, P., Touboul, P. J., Fève, J. M., & Alpérovitch, A. (2001). Sustained anxiety and 4-year progression of carotid atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 21, 136–141.

    Article  PubMed  Google Scholar 

  • Phillips, A. C., Batty, G. D., Gale, C. R., Deary, I. J., Osborn, D., MacIntyre, K., & Carroll, D. (2009). Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: The Vietnam experience study. Psychosomatic Medicine, 71(4), 395–403.

    Article  PubMed  Google Scholar 

  • Pieper, S., Brosschot, J. F., van der Leeden, R., & Thayer, J. F. (2007). Cardiac effects of momentary assessed worry episodes and stressful events. Psychosomatic Medicine, 69, 901–909.

    Article  PubMed  Google Scholar 

  • Purvis, J. A., Cunningham, E. L., McGlinchey, P. G., & Barr, S. H. (2009). Drugs, electrolytes and takotsubo cardiomyopathy: Triple aetiology of acquired long QT syndrome and torsades de pointes. Ulster Medical Journal, 78(3), 188–189.

    PubMed Central  PubMed  Google Scholar 

  • Radhakrishna, R. K. A., & Yeragani, V. K. (2001). Decreased chaos and increased non-linearity of heart rate time series in patients with panic disorder. Autonomic Neurosciences, 88, 99–108.

    Article  Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the predictions of fearfulness. Behaviour Research & Therapy, 24(1), 1–8.

    Article  Google Scholar 

  • Ridker, P. M. (2007). C-reactive protein and the prediction of cardiovascular events amongst those at intermediate risk: Moving an inflammatory hypothesis toward consensus. Journal of the American College of Cardiology, 49(21), 2129–2138.

    Article  PubMed  Google Scholar 

  • Roest, A. M., Martens, E. J., De Jonge, P., & Denollet, J. (2010). Anxiety and risk of incident of coronary heart disease: A meta-analysis. Journal of the American College of Cardiology, 56(1), 38–46.

    Article  PubMed  Google Scholar 

  • Rosengren, S., Hawkin, S., Ounpuu, S., et al. (2004). Association of psychosocial risk factors with risk of acute myocardial infarction in 11,119 cases and 13,648 controls from 52 countries (the INTERHEART study): Case–control study. Lancet, 364, 953–962.

    Article  PubMed  Google Scholar 

  • Rothenbacher, D., Hahmann, H., Wusten, B., Koenig, W., & Brenner, H. (2007). Symptoms of anxiety and depression in patients with stable coronary heart disease: Prognostic value and consideration of pathogenic links. European Journal Cardiovascular Preven Rehabiliation, 14(4), 547–554.

    Article  Google Scholar 

  • Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99, 2199–2217.

    Article  Google Scholar 

  • Saavedra, J., Sanchez-Lemus, E., & Benicky, J. (2011). Blockade of brain angiotensin II AT1 receptors ameliorates stress, anxiety, brain inflammation and ischemia: Therapeutic implications. Psychoneuroendocrinology, 36(1), 1–18.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sovari, A. A., Cesario, D., Kocheril, A. G., & Brugada, R. (2008). Multiple episodes of ventricular tachycardia induced by silent coronary vasospasm. Journal of Interventional Cardiology and Electrophysiology, 21(3), 223–226.

    Article  Google Scholar 

  • Steptoe, A., Wikman, A., Molloy, G. J., Messerli-Burgy, N., & Kaski, J. C. (2013). Inflammation and symptoms of depression and anxiety in patients with acute coronary heart disease. Brain, Behaviour & Immunity, 31, 183–188.

    Article  Google Scholar 

  • Thomsen, S. B., Rathke, C. N., Zerahn, B., & Vestergaard, H. (2010). Increased levels of calcification marker matrix GIa protein and the inflammatory markers YKL-40 and CRP in patients with type 2 diabetes and ischemic heart disease. Cardiovascular Diabetology, 9, 86.

    Article  PubMed Central  PubMed  Google Scholar 

  • Thornton, E. W., Bundred, P., Tytherleigh, M., & Davies, A. D. M. (2006). Anxiety, depression and myocardial infarction: A survey of their impact on consultation rates before and after an acute primary episode. British Journal of Cardiology, 13(3), 220–224.

    Google Scholar 

  • Thrall, G., Lip, G. Y. H. P., Carroll, D., & Lane, D. (2007). Depression, anxiety, and quality of life in patients with atrial fibrillation. Chest, 132(4), 1259–1264.

    Article  PubMed  Google Scholar 

  • Thurston, R. C., Rewak, M., & Kubzansky, L. D. (2013). An anxious heart: Anxiety and the onset of cardiovascular diseases. Progress in Cardiovascular Diseases, 55(6), 524–537.

    Article  PubMed  Google Scholar 

  • Uzun, S., Vural, H., Uzun, M., & Yokusoglu, M. (2008). State and trait anxiety levels before coronary angiography. Journal of Clinical Nursing, 17(5), 602–607.

    Article  PubMed  Google Scholar 

  • Walters, K., Rait, G., Petersen, I., & Williams, R. (2008). Panic disorder and risk of new onset coronary heart disease, acute myocardial infarction, and cardiac mortality: Cohort study using the general practice research database. European Heart Journal, 29(24), 2981–2988.

    Article  PubMed  Google Scholar 

  • Wilbert-Lampen, U., Leistner, D., Greven, S., Pohl, T., Sper, S., Völker, C., Güthlin, D., Plasse, A., Knez, A., Küchenhoff, H., & Steinbeck, G. (2008). Cardiovascular events during World Cup soccer. New England Journal of Medicine, 358, 475–483.

    Article  PubMed  Google Scholar 

  • Wilkinson, D. J., Thompson, J. M., Lambert, G. W., Jennings, G. L., Schwarz, R. G., Jefferys, D., Turner, A. G., & Esler, M. D. (1998). Sympathetic activity in patients with panic disorder at rest, under laboratory mental stress, and during panic attacks. Archives of General Psychiatry, 55(6), 511–520.

    Article  PubMed  Google Scholar 

  • Wulsin, L. R., & Singal, B. M. (2003). Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosomatic Medicine, 65, 201–210.

    Article  PubMed  Google Scholar 

  • Yeragani, V. K., Pohl, R., Berger, R., Balon, R., Ramesh, C., Glitz, D., Srinivasan, K., & Weinberg, P. (1993). Decreased heart rate variability in panic disorder patients: A study of power spectral analysis of heart rate. Psychiatry Research, 46(1), 89–103.

    Article  PubMed  Google Scholar 

  • Yeragani, V. K., Pohl, R., Jampala, V. C., Balon, R. R., & Srinivasan, K. (2000). Increased QT variability in patients with panic disorder and depression. Psychiatry Research, 1093(3), 225–235.

    Article  Google Scholar 

  • Zafar, M. U., Paz-Yepes, M., Shimbo, D., Vilahur, G., Burg, M. M., Chaplin, W., Fuster, V., Davidson, K. W., & Badimon, J. J. (2010). Anxiety is a better predictor of platelet reactivity in coronary artery disease patients than depression. European Heart Journal, 31(13), 1573–1582.

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. MonashHEART, Monash Cardiovascular Research Centre, Monash Health & Department of Medicine (SCS at Monash), Monash University, 271 Police Road, Mulgrave, 3170, Melbourne, VIC, Australia

    Marlies E. Alvarenga

  2. The Medical School, Australian National University, 0200, Canberra, ACT, Australia

    Don Byrne

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  1. Marlies E. Alvarenga
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  2. Don Byrne
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Correspondence to Marlies E. Alvarenga .

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Editors and Affiliations

  1. Monash University, Victoria, Australia

    Marlies Alvarenga

  2. Australia National University, Canberra, Aust Capital Terr, Australia

    Don Byrne

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© 2015 Springer Science+Business Media Singapore

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Alvarenga, M.E., Byrne, D. (2015). Anxiety and Cardiovascular Disease: Epidemiology and Proposed Mechanisms. In: Alvarenga, M., Byrne, D. (eds) Handbook of Psychocardiology. Springer, Singapore. https://doi.org/10.1007/978-981-4560-53-5_10-1

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  • DOI: https://doi.org/10.1007/978-981-4560-53-5_10-1

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