Cited by 230Cardiac Health and Mental HealthHeart Rate Variability and Autonomic ControlAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease

Tully, Phillip J., Cosh, Suzie M., Baune, Bernhard T.·2013·Psychology, Health & Medicine

DOI 10.1080/13548506.2012.749355

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Abstract

OBJECTIVE: The aims of this review article are to present psychophysiological and behavioral pathways for the involvement of worry and generalized anxiety disorder (GAD) upon cardiovascular function. The review will focus on persons with and without coronary heart disease (CHD), and encompass etiological and prognostic studies. METHODS: Articles (1975-2011) reporting on GAD or worry affecting CHD prognosis or cardiovascular function were found using MEDLINE, EMBASE, SCOPUS and PsychINFO database searches, and extracted to form a narrative review. RESULTS: Available evidence in experimental and observational studies in CHD free samples consistently showed that worry was associated with diminished heart rate variability (HRV) and elevated heart rate. Worry and GAD were commonly associated with blood pressure and diagnosed hypertension or medication use in both disease-free and established CHD populations. No evidence was found to support worry being beneficial to cardiovascular function or conducive to health promoting behaviors. The literature indicated that measures of worry were associated with fatal and nonfatal CHD in seven etiological studies of initially disease-free individuals; however, females were underrepresented. Three studies reported that GAD was associated with poorer prognosis in establish CHD, independent of depression. The median GAD prevalence was 10.4% in 3266 patients across 15 studies, suggesting that GAD is marginally less common in CHD samples than is depression. CONCLUSIONS: A growing literature highlights the association between worry and development of CHD. The association between worry, GAD and CHD risk factors (e.g. blood pressure), and HRV are leading mechanisms of cardiopathogenesis that may affect cardiovascular function. Findings regarding worry and GAD in established CHD are less clear.

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Authors: Tully, P. J., Cosh, S. M., & Baune, B. T.
Affiliations: Flinders University (AU)
,
The University of Adelaide (AU)
Corresponding author: Tully, Phillip J.
ORCID: Tully, Phillip J.
Baune, Bernhard T.
Venue: Psychology, Health & Medicine
Publisher: Informa UK Limited
Published: 2013-01-16
Volume: 18
Issue: 6
Pages: 627-644
ISSN: 1354-8506 (ISSN-L)
1465-3966
DOI: 10.1080/13548506.2012.749355
OpenAlex: W2063250478
Cited by: 230
References: 60
Citations by year: 2026: 6 · 2025: 9 · 2024: 17 · 2023: 16 · 2022: 17 · 2021: 35 · 2020: 25 · 2019: 10 · 2018: 24 · 2017: 22 · 2016: 18 · 2015: 12 · 2014: 12 · 2013: 6
FWCI: 10.82
Type: journal article
Language: en
Open access: closed
Locations: Psychology Health & Medicine (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Figshare (submittedVersion)
RUNE (Research UNE) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: worry, generalized anxiety disorder, coronary artery disease, cardiovascular health, heart rate variability, blood pressure, hypertension, cardiovascular risk factors, behavioral pathways, prognosis
MeSH terms: Anxiety Disorders, Blood Pressure, Coronary Disease, Depression, Heart Rate, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Prognosis, Risk Factors, Stress, Psychological, Comorbidity

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A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease

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