Men prone to anxiety and worry may develop heart disease and diabetes risk factors at younger ages

  • In a long-term study of men in the United States, more risk factors for heart disease and type 2 diabetes emerged early in life among those who reported more feelings of anxiety or feeling tired than those with lower levels of anxiety.
  • Study results suggest that men prone to anxiety and worry may need to pay extra attention to cardiovascular disease risk factors, such as maintaining a healthy weight and taking blood pressure or cholesterol medications, if needed.
  • The findings also raise the possibility that treating anxiety disorders may reduce the risk of cardiovascular disease.

Middle-aged men who experience anxiety and worry may have a higher biological risk of developing heart disease, stroke and type 2 diabetes, also known as cardiovascular disease, as they age, according to new research published today in Journal of the American Heart Association, an open access journal of the American Heart Association.

“While the participants were primarily white men, our findings suggest that higher levels of anxiety or worry in men are related to biological processes that may lead to heart disease and metabolic conditions, and these associations may be present very early in life.” from what is commonly known — potentially during childhood or adulthood,” said lead author Luena Lee, associate professor of psychiatry at Boston University School of Medicine, and researcher and clinical psychologist at the National PTSD Center in the US Department of Health. American Veterans, both in Boston.

To track the relationship between anxiety and cardiovascular disease risk factors over time, researchers analyzed data for participants in the Standard Aging Study, a longitudinal study of the processes of aging in men, founded at the US Veterans Affairs Clinic in Boston in 1961. The study includes Both veterans and non-veterans. This analysis included 1,561 men (97% white), who had a mean age of 53 years in 1975. The men completed baseline assessments of neuroticism and anxiety and had no cardiovascular disease or cancer at that time. Rate the Neurotic Personality Inventory on a scale of 0-9. Additionally, the anxiety rating tool asked how often they worry about each of the 20 items, with 0 meaning never and 4 meaning all time.

“Neuroticism is a personality trait characterized by a tendency to interpret situations as threatening, stressful, and/or overwhelming. Individuals with high levels of neuroticism are prone to experience negative emotions — such as fear, anxiety, sadness, and anger — more intensely and more frequently,” Lee said. Anxiety refers to our attempts to solve problems about an issue whose future outcome is uncertain and may be positive or negative Anxiety can be adaptive, for example, when it leads us to constructive solutions However, anxiety can also be unhealthy, especially when it becomes outside The scope of control interferes with our daily performance.”

After the baseline evaluation, the men underwent physical examinations and blood tests every 3-5 years until they died or withdrew from the study. The research team used follow-up data up to 2015. During the follow-up visits, seven risk factors for cardiac metabolism were measured: systolic blood pressure (the top number), and blood pressure. Diastolic blood pressure (the bottom number). total cholesterol; Triglyceride. obesity (assessed by body mass index); Fasting blood sugar levels. and erythrocyte sedimentation rate (ESR), a marker of inflammation.

The risk factor for cardiovascular disease was considered in the higher risk range if the risk factor test results were above the upper limit established by national guidelines, or if the participant was taking any medications to manage this risk factor (eg, statins). Cut-off points for ESR were not standardized as a risk factor, so a participant was classified as high-risk if they were in the top 25% of those tested. Each participant was assigned a risk factor number score, one point for each of the seven risk factors categorized as high risk. The men were then stratified based on whether or not they had developed six or more high-risk factors during the follow-up period.

“Having six or more high-risk cardiac metabolic markers indicates that an individual is very likely to develop or have already had cardiovascular disease,” Lee told me.

The researchers found:

  • Between the ages of 33 to 65 years, the average number of high risk factors for cardiac metabolism increased by about one per decade, with an average of 3.8 risk factors by age 65, followed by a slower increase each decade after age 65.
  • At all ages, participants with high levels of neuroticism had a higher number of high-risk cardiometabolic factors.
  • Higher neuroticism was associated with a 13% higher likelihood of having six or more cardiovascular disease risk factors, after adjusting for demographic characteristics (eg, income, education) and family history of heart disease.
  • Higher anxiety levels were associated with a 10% higher likelihood of having six or more cardiovascular disease risk factors after adjusting for demographic characteristics.

“We found that the risk of cardiovascular disease increases as men age, from 30 to 80, regardless of anxiety levels, while men who have consistently higher levels of anxiety and worry have a higher likelihood of developing cardiovascular disease over time. Compared to those with lower levels of anxiety or worry,” he told me.

The researchers had no data on whether the participants had been diagnosed with an anxiety disorder. Standard evidence-based treatment for anxiety disorders includes psychotherapy or medication, or a combination of the two.

“While we do not know if treating anxiety and stress may reduce cardiac metabolic risk, anxious and anxious individuals should pay more attention to cardiovascular health. For example, by performing routine health checks and taking a proactive role in managing levels of disease risk. cardiovascular disease (such as taking medications for high blood pressure and maintaining a healthy weight), they may be able to reduce the likelihood of developing cardiovascular disease,” Lee said.

It is unclear to what extent the results of this analysis are generalizable to the public because all study participants were all male and nearly all were white. In addition, although the participants were followed for four decades, they were still middle-aged when the study began.

“It will be important for future studies to assess whether these associations exist among women, people from diverse racial and ethnic groups, and in more socioeconomically diverse samples, and to consider the extent to which anxiety is associated with the development of cardiac metabolic risk in individuals much younger than me,” Lee said.

Reference: January 24, 2022, Journal of the American Heart Association.
DOI: 10.1161 / JAHA.121.02206

Co-authors are Kevin J. Grimm, Ph.D.; Avron Spiro III, Ph.D.; and Laura D. Kubzansky, MPH, Ph.D. The authors’ disclosures are listed in the manuscript.

The study was supported by the National Institute on Aging and the National Center for the Advancement of Translational Sciences, both divisions of the National Institutes of Health.