An older woman who has at least one full blown panic attack may be at a higher risk of having a heart attack or stroke, as well as death, in the subsequent five years, compared to an older woman who has never had a panic attack. You can read about this in an article in Archives of General Psychiatry (JAMA/Archives).

The authors inform that when a patient experiences a panic attack there is a sudden development of fear, anxiety or intense discomfort, which is accompanied by at least four additional symptoms. The attacks may take place intermittently or as part of an anxiety disorder, e.g. social anxiety disorder, panic disorder or a phobia.

Jordan W. Smoller, M.D., Sc.D., Massachusetts General Hospital, Boston, and team examined 3,369 healthy postmenopausal women, their average age was 65.9 years (aged 51-83). During the period 1997-2000, when they entered the study, they completed a questionnaire which included questions about the occurrence of panic attacks during the previous six months. They were all followed-up 5.3 years later to find out whether they had had a heart attack or stroke, or had died of from any cause.

Approximately 10% of the women had initially reported experiencing a full-blown panic attack during the six months leading up to their filling in the questionnaire. After making adjustments for other cardiovascular risk factors, the researchers found that a woman who had had at least one panic attack had four times the risk of a heart attack (myocardial infarction), three times the risk of having a heart attack or stroke, and almost twice the risk of death from any cause. Even after controlling for depression, the links still stood, leading the researchers to suggest that panic attacks may well be a separate independent risk factor for cardiovascular events.

This study adds panic attacks to the list of psychiatric symptoms and emotions that are associated with cardiovascular risk, including anger and hostility, and depression, the authors write. Panic attacks might be linked to other cardiovascular risk factors, such as high blood pressure (hypertension). On the other hand, anxiety might contribute to adverse cardiovascular effects, such as coronary artery spasm, a tendency toward increasing blood clotting or heart rhythm disturbances.

The authors concluded "These results suggest that panic anxiety is a marker for increased risk of cardiovascular morbidity and mortality among postmenopausal women. Future studies are needed to clarify the causal connection, if any, between panic attacks and cardiovascular events. Our results imply, however, that older women with a recent history of panic attacks represent a subgroup at elevated risk of myocardial infarction and stroke in whom careful monitoring and cardiovascular risk reduction may be particularly important."

Arch Gen Psychiatry. 2007;64(10):1153-1160
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