Anxiety and new onset of cardiovascular disease: critical review and meta-analysis
Open accessAbstract
BACKGROUND: Anxiety has been associated with new-onset cardiovascular disease (CVD), but the quality of this relationship is unclear. Only if anxiety is a causal, independent cardiovascular risk factor might it be a target for CVD prevention. AIMS: To determine and examine the independent association and causality between anxiety and incident CVD. METHOD: PubMed, EMBASE and PsycINFO databases were searched up to October 2013. A review of Hill's criteria for causality and random effects meta-analysis were conducted of prospective, population-based studies examining anxiety and incident CVD in people free from CVD at baseline. RESULTS: The meta-analysis comprised 37 papers (n = 1 565 699). The follow-up ranged from 1 to 24 years. Anxiety was associated with a 52% increased incidence of CVD (hazard ratio = 1.52, 95% CI 1.36-1.71). The risk seemed independent of traditional risk factors and depression. The evaluation of Hill's criteria largely argued in favour of causality. CONCLUSIONS: Anxiety may be of interest for CVD prevention. Future research should examine biological and behavioural underpinnings of the association in order to identify targets for intervention.
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The largest gaps in life expectancy for people with severe mental illness are observed in low-income settings.
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- Authors
- Batelaan, N. M., Seldenrijk, A., Bot, M., van Balkom, A. J. L. M., & Penninx, B. W. J. H.
- Affiliations
- Amsterdam Public Health (NL)
- Corresponding author
- Batelaan, Neeltje M.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-03
- Volume
- 208
- Issue
- 3
- Pages
- 223-231
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2294500753
- Cited by
- 362
- References
- 116
- Citations by year
- 2026: 25 · 2025: 27 · 2024: 29 · 2023: 76 · 2022: 55 · 2021: 42 · 2020: 43 · 2019: 17 · 2018: 23 · 2017: 15 · 2016: 10
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Vrije Universiteit Amsterdam
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (91811602)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anxiety, cardiovascular disease, incident cardiovascular disease, cardiovascular risk factors, causality, Hill's criteria, depression, cardiovascular disease prevention, psychological risk factors
- MeSH terms
- Anxiety Disorders, Cardiovascular Diseases, Depressive Disorder, Humans, Risk Factors, Incidence
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