Panic attacks linked to higher risk of heart problems
16 December 2008
People who have been diagnosed with panic attacks or panic disorder have a greater risk than others of subsequently developing heart disease or suffering a heart attack, with higher rates occurring in younger people, according to research published in the 'European Heart Journal' on 11 December.
The study has found that people who were under fifty (though not those over fifty), when first diagnosed, had a significantly higher risk of subsequent heart attacks (or myocardial infarctions, MI). It also found that there was a significantly higher incidence of subsequent coronary heart disease (CHD) in people diagnosed with panic attacks/disorder at all ages, but this was more marked in those under fifty. However, the research also shows that the risk of dying from CHD was actually reduced among people of all ages who had been diagnosed with panic attacks/disorder.
The study is the first to discover this information, having looked at over 400,000 people of all ages in the UK, selected from a primary care population which is broadly equivalent to that of other countries with a similar socio-demographic structure.
Dr Kate Walters (UCL Primary Care & Population Health, PCPH), who led the research, said: "Not much is known about the relationship between panic disorder and cardiac disease. The symptoms of panic attacks can closely mimic those of a heart attack or acute cardiac disease, and it seems that there may be a complex relationship between them.
"Our findings have significant implications for clinicians. Panic attacks were associated with a significant increased risk of a subsequent diagnosis of CHD and acute MI in those aged younger than fifty. This may be due to initial misdiagnosis of CHD as panic attacks, or a true underlying increased risk of CHD with panic attacks. Clinicians should be vigilant for this possibility when diagnosing and treating people presenting with symptoms of panic."
Dr Walters and her colleagues looked at primary care medical records for 60,000 adults diagnosed with panic attacks/disorder and 350,000 adults who did not have the condition. They found that those aged under fifty were 38% as likely to have a heart attack and 44% as likely to develop heart disease subsequently than people who had not been diagnosed with the condition. For people aged over 50 there was a slightly increased risk of heart disease (11%). However, when the researchers looked at deaths among adults diagnosed with panic attacks/disorder, they found that for all ages the risk of death from heart disease was reduced by about a quarter (24%) compared with the normal population.
Dr Walters speculated about the possible reasons for the reduced risk of death. "This might be because the higher risk of coronary heart disease and heart attacks occurred amongst younger people who have fewer heart-related deaths generally; or it might be because people with panic disorders go to their doctors earlier and more frequently and, therefore, are more likely to have their heart disease identified and treated early, thus reducing the likelihood of dying from it."
She stressed that people who have been diagnosed with panic attacks/disorder should not worry about her findings but should consult their doctors. "While there is a small increased risk among people diagnosed by their GP with panic attacks/disorder, the vast majority of people with panic attacks will not go on to have a heart attack or heart diseases such as angina," she said. "People should be encouraged to go back to their GPs for further assessment if their symptoms continue or reoccur."
The PCPH's strategic aim is to deliver high-quality teaching in community-based primary care and public health, and to undertake a programme of internationally competitive multidisciplinary research addressing the management and prevention of disease in individuals and populations in areas of priority to the health of the public. The department works closely with the MRC Clinical Trials unit and the General Practice Research Framework (GPRF). Together with the GPRF and UCL Mental Health Sciences, it runs PRIMENT, a fully registered UK CRC Clinical Trials Unit, one of the few in the UK with expertise in the design, conduct and analysis of trials and other large, well-designed studies in primary care and mental health research.