Anxiety disorders latest worry in high blood
pressure
Toronto - Family doctors and psychiatrists should carefully
monitor the heart health of patients with anxiety disorders, Dr.
Simon Bacon told the Canadian Cardiovascular Congress 2008, co-
hosted by the Heart and Stroke Foundation and the Canadian
Cardiovascular Society.
"People with anxiety disorders are four times more likely to
develop high blood pressure (hypertension) over one year than
those of us who are anxiety free," says Dr. Bacon, a Heart and
Stroke Foundation researcher at the Montreal Heart Institute.
"Hypertension is a leading risk factor for stroke and heart
disease."
Anxiety disorders are among the most common of all forms of
mental illness, according to Dr. Bacon. People affected
frequently (often daily) experience intense feelings of fear and
distress that are typically out of proportion to the actual
threat or danger. They also tend to disrupt daily functioning,
including personal relationships and the ability to work. They
include general anxiety disorder, panic disorder, obsessive
compulsive disorder, and social phobia.
"Anxiety can cause increases in your blood pressure and heart
rate. If it is persistent, those effects could be damaging," says
Heart and Stroke Foundation researcher and spokesperson Dr. Brian
Baker. "While we still need more understanding about how anxiety
is associated with sustained high blood pressure, it is important
that blood pressure is regularly monitored in people with anxiety
disorders and that therapy - including anxiety management - is
considered."
Dr. Bacon says that anxiety can lead to unhealthy lifestyle
choices, including poor diet, smoking, and physical inactivity,
which can also increase a person's overall risk for heart disease
and stroke.
"In the general population, at any point in time, anxiety
disorders affect approximately 12 per cent of people," says Dr.
Bacon. "And, anxiety disorders are generally twice more common
among women than among men."
Dr. Bacon's research followed 185 patients with normal blood
pressures for one year. The mean age of the patients was 58
years; 39 per cent were women, and 61 per cent were men. Sixteen
per cent of patients had an anxiety disorder and 14 per cent had
a mood disorder. Mood disorders include major depression, minor
depression, and dysthymia.
Each patient underwent a structured psychiatric interview and
provided information about their health. At the end of one year
Dr. Bacon again collected information about participants'
health.
Four per cent of the subjects without an anxiety disorder
developed high blood pressure. However, 14 per cent of those
who had an anxiety disorder developed hypertension.
The increase in high blood pressure did not apply to patients
with mood disorders. "Our study also showed that patients who
developed mood disorders were not at a higher risk of developing
hypertension," says Dr. Bacon.
"It is possible to have both," says Dr. Bacon. "It is very common
to be depressed and anxious. But our study separated them out
and found - at least over one year - that anxiety is a major
culprit in hypertension."
Depression has a pronounced but indirect effect on the
development of hypertension. People who are depressed tend to
exercise less and make unhealthy lifestyle choices, according to
Dr. Bacon.
But anxiety may create a direct, physiological response - a shock
to the nervous system:
- Unlike the relatively mild, brief anxiety caused by a
stressful event (such as speaking in public or a first date),
anxiety disorders last at least six months and can get worse if
they are not treated.
- Anxiety disorders commonly occur along with other mental or
physical illnesses, including depression, alcohol, or substance
abuse, which may mask anxiety symptoms or make them worse. In
some cases, these other illnesses need to be treated before a
person will respond to treatment for the anxiety disorder.
- Effective therapies for anxiety disorders are available.
Most people with anxiety disorders lead productive, fulfilling
lives. People who think they have an anxiety disorder should seek
information and treatment right away.
"One of the main messages here is that it is important to look
after one's mental health as much as one's physical health," says
Dr. Bacon. "If you have chronic anxious feelings, this could lead
to worse heart health. There is no need to suffer - there are
very good treatments out there."
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Statements and conclusions of study authors are solely those of
the study authors and do not necessarily reflect Foundation or
CCS policy or position. The Heart and Stroke Foundation of Canada
and the Canadian Cardiovascular Society make no representation or
warranty as to their accuracy or reliability.
The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-
based health charity, leads in eliminating heart disease and
stroke and reducing their impact through the advancement of
research and its application, the promotion of healthy living,
and advocacy.
