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Harvard Medical School
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General Medical Questions
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Question : Does anxiety increase the risk of heart disease?
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The Trusted Source
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Howard LeWine, M.D.

Michael Craig Miller, M.D., is Senior Editor of Mental Health Publishing at Harvard Health Publications. He is an assistant professor of psychiatry at Harvard Medical School. Dr. Miller is in clinical practice at Beth Israel Deaconess Medical Center, where he has been on staff for more than 25 years.

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October 08, 2013
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Anxiety does appear to have a modest negative impact on heart health.

Of course, heart disease symptoms can bring on anxiety. And severe anxiety may look like heart disease. For example, panic symptoms can mimic a heart attack.

And both illnesses are common. So it’s hard to study the relationship between the two.

People who are anxious may have habits (like smoking or overeating) that increase heart disease risk. So studies must take into account such factors to determine anxiety’s direct effect on the heart.

Carefully-controlled studies of large populations do link generalized anxiety disorder (GAD) to heart disease. People with GAD have frequent and often overwhelming anxiety.

Constant anxiety of this type is associated with an increased risk of heart attack and other cardiac events. This is particularly true in patients who already have a diagnosis of heart disease.

We aren’t sure how generalized anxiety disorder increases heart disease risk.

GAD may cause surges of cortisol and other stress hormones. These chemicals are involved in the “fight or flight” response. They may trigger heart attacks and other heart problems.

Another theory is that people with anxiety have low levels of omega-3 fatty acids. And a low level is associated with a higher risk of heart disease.

Depression has many factors in common with GAD. So depression may be the real culprit boosting the risk of heart disease.

It’s probably not worth pondering these differences. At the very discuss symptoms of anxiety (and depression) with your doctor. That’s especially true if you are being treated for heart disease.

There are many good treatments for generalized anxiety. Medicine and psychotherapy are both very effective. Treatment can improve your quality of life. And by treating anxiety, you may also reduce your heart disease risk.

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