Anxiety can affect heart health, say doctors

This is an acute response with raise in heart rate and blood pressure triggered by an adrenergic surge, which will settle down with a normal adaptive response once the perceived threat is gone, and this is a physiological response.

But for some there is a constant state on anxiety, over a prolonged period, interfering with their daily activities, their family life and makes them less productive in their professional life, which is suggestive of an anxiety (panic) disorder, which is a pathological response, say medicos.

Anxiety disorders including post-traumatic stress disorder and panic disorder can lead to behavioural changes such as less healthy diet, low physical activity, reduced treatment adherence and smoking. There can be physiologic changes such as autonomic dysfunction, inflammation, platelet dysfunction and endothelial dysfunction. These changes can lead to adverse cardiac outcomes.

“Anxiety disorders are associated with the onset and progression of cardiac disease. They can increase the blood pressure, heart rate and adversely affect heart rate variability, thereby increasing the risk of heart attack, stroke, heart failure and death by 25%. Both physiologic and health behaviour mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease,” said Dr Rajaram Anantharaman, Senior Cardiologist, Frontier Lifeline Hospital.

Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Both pharmacologic and psychotherapeutic interventions like cognitive behavioural therapy (CBT) and other complementary therapies like exercise, relaxation techniques such as meditation& yoga, biofeedback and hypnosis can help in the management of anxiety disorders, and they are generally safe and effective, added Dr Rajaram.

With careful diagnosis and appropriate treatment, anxious patients could have improved quality of life, functioning, and cardiac health. People with anxiety may also have habits like smoking and excessive eating. This will contribute to the development of heart disease.

“Anxiety, depression can release stress hormones which will increase heart rate and blood pressure. With anxiety the physiological stress response starts malfunctioning. This will result in inflammation in the coronary arteries and causes atherosclerosis. Anxiety also makes platelet dysfunction and may cause blocks in the coronary artery and heart attack. Any increase in heart rate caused by anxiety may precipitate heart attack in people with coronary artery disease,” said Dr Suresh Rao KG, Head of Department, Critical Care and Cardiac Anaesthesia, Fortis Malar Hospital.

Medicos say that meditation and yoga may help to overcome anxiety. Spending time with people whom they like, balanced diet and physical activity are some of the useful things to overcome anxiety. Medications to treat anxiety may be needed in some but some cardiac medications can prevent the adverse effects of anxiety on the heart, added Dr Suresh.