Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men

  • Shen B
  • Avivi Y
  • Todaro J
  • et al.
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Objectives This study investigated whether anxiety characteristics<br />independently predicted the onset of myocardial infarction (MI) over an<br />average of 12.4 years and whether this relationship was independent of<br />other psychologic variables and risk factors.<br />Background Although several psychosocial factors have been associated<br />with risk for MI, anxiety has not been examined extensively. Earlier<br />studies also rarely addressed whether the association between a<br />psychologic variable and MI was specific and independent of other<br />psychosocial correlates.<br />Methods Participants were 735 older men (mean age 60 years) without a<br />history of coronary disease or diabetes at baseline from the Normative<br />Aging Study. Anxiety characteristics were assessed with 4 scales<br />(psychasthenia, social introversion, phobia, and manifest anxiety) and<br />an overall anxiety factor derived from these scales.<br />Results Anxiety characteristics independently and prospectively<br />predicted MI incidence after controlling for age, education, marital<br />status, fasting glucose, body mass index, high-density lipoprotein<br />cholesterol, and systolic blood pressure in proportional hazards models.<br />The adjusted relative risk (95{%} confidence interval {{}[{}}CI]) of MI<br />associated with each standard deviation increase in anxiety variable was<br />1.37 (95{%} CI 1.12 to 1.68) for psychasthenia, 1.31 (95{%} CI 1.05 to<br />1.63) for social introversion, 1.36 (95{%} CI 1.10 to 1.68) for phobia,<br />1.42 (95{%} CI 1.14 to 1.76) for manifest anxiety, and 1.43 (95{%} CI 1.17<br />to 1.75) for overall anxiety. These relationships remained significant<br />after further adjusting for health behaviors (drinking, smoking, and<br />caloric intake), medications for hypertension, high cholesterol, and<br />diabetes during follow-up and additional psychologic variables<br />(depression, type A behavior, hostility, anger, and negative emotion).<br />Conclusions Anxiety-prone dispositions appear to be a robust and<br />independent risk factor of MI among older men.




Shen, B.-J., Avivi, Y. E., Todaro, J. F., Spiro, A., Laurenceau, J.-P., Ward, K. D., & Niaura, R. (2008). Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men. Journal of the American College of Cardiology, 51(2), 113–119.

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