Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men

Abstract

Objectives This study investigated whether anxiety characteristicsindependently predicted the onset of myocardial infarction (MI) over anaverage of 12.4 years and whether this relationship was independent ofother psychologic variables and risk factors.Background Although several psychosocial factors have been associatedwith risk for MI, anxiety has not been examined extensively. Earlierstudies also rarely addressed whether the association between apsychologic variable and MI was specific and independent of otherpsychosocial correlates.Methods Participants were 735 older men (mean age 60 years) without ahistory of coronary disease or diabetes at baseline from the NormativeAging Study. Anxiety characteristics were assessed with 4 scales(psychasthenia, social introversion, phobia, and manifest anxiety) andan overall anxiety factor derived from these scales.Results Anxiety characteristics independently and prospectivelypredicted MI incidence after controlling for age, education, maritalstatus, fasting glucose, body mass index, high-density lipoproteincholesterol, and systolic blood pressure in proportional hazards models.The adjusted relative risk (95{%} confidence interval {{}[{}}CI]) of MIassociated with each standard deviation increase in anxiety variable was1.37 (95{%} CI 1.12 to 1.68) for psychasthenia, 1.31 (95{%} CI 1.05 to1.63) for social introversion, 1.36 (95{%} CI 1.10 to 1.68) for phobia,1.42 (95{%} CI 1.14 to 1.76) for manifest anxiety, and 1.43 (95{%} CI 1.17to 1.75) for overall anxiety. These relationships remained significantafter further adjusting for health behaviors (drinking, smoking, andcaloric intake), medications for hypertension, high cholesterol, anddiabetes during follow-up and additional psychologic variables(depression, type A behavior, hostility, anger, and negative emotion).Conclusions Anxiety-prone dispositions appear to be a robust andindependent risk factor of MI among older men.