Disease severity, health behaviors or biological mediators do not explain the association
WEDNESDAY, July 7 (HealthDay News) -- Generalized anxiety disorder (GAD) is associated with an increased risk of cardiovascular events in patients with stable coronary heart disease (CHD), and disease severity does not explain this association, according to a study in the July issue of the Archives of General Psychiatry.
In a prospective cohort study (Heart and Soul Study), Elisabeth J. Martens, Ph.D., of Tilburg University in the Netherlands, and colleagues recruited 1,015 outpatients with stable CHD between Sept. 11, 2000, and Dec. 20, 2002, from 12 outpatient clinics in the San Francisco Bay Area. Patients were followed through March 18, 2009.
In the 106 patients with GAD, the researchers found that the age-adjusted annual rate of cardiovascular events was 9.6 percent, compared to 6.6 percent in the 909 patients without GAD. In addition, GAD remained associated with a 62 percent higher rate of cardiovascular events after adjusting for demographic characteristics, comorbid conditions, cardiac disease severity, and medication use. Further adjustment for other potential behavioral and biological mediators had little impact on the association (hazard ratio, 1.74).
"We found a strong and robust association between GAD and cardiovascular events that could not be explained by disease severity, health behaviors, or biological mediators," the authors write. "The results of the study indicate the need for future research to identify the underlying processes by which GAD contributes to adverse events in patients with CHD and to test interventions to alleviate this increased risk."
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