Blood Pressure and Cholesterol – The Affect of Personality and Panic Attacks

Lisa Nelson RD: What role does personality play in a person’s heart disease risk? Does temperament have a direct affect on cholesterol levels or blood pressure?

Dr. Shelby-Lane: Temperament and personality have a definite effect on blood pressure and on heart disease. This is a great question and it has been studied by the experts, as you will note in the following excerpts. Heart disease consists of congenital abnormalities, arrhythmias, lipid abnormalities acquired and congenital, functional and physiologic problems, risk factors such as diabetes and metabolic syndrome, structural disease and valvular problems, heart failure, acquired disease such as coronary artery disuse, and infectious diseases along with diseases related to blood vessel structure. Again, anxiety, stress, and stress related disorders can have an effect on major hormones, heart rate and heart health and heart disease. Nutritional abnormalities can also affect heart performance.

New research suggests that people who suffer from panic attacks are at increased risk of developing heart disease.

Dr Kate Walters and colleagues at University College London examined medical records of more than 400,000 people, including 57,615 who had been diagnosed with panic attacks. Results showed that people who were younger than 50 when they were first diagnosed with panic attack were 38% more likely to have a heart attack and 44% more likely to develop heart disease than those without the condition. Those who were older than 50 at the time of diagnosis did not have an increased risk of heart attack, but were 11% more likely to develop heart disease than those without the condition.

Intriguingly, the results also showed that while panic attack sufferers were at increased risk of developing heart disease, they were seemingly less likely to die from it.

Why people who suffer from panic attacks should be at increased risk of developing heart disease is unclear. According to the study, authors put forward several theories, one being that panic disorders might trigger nervous system changes which could promote the clogging of arteries. Another theory is that people may have been misdiagnosed as having panic attacks when they actually have coronary heart disease. “Clinicians should be vigilant for this possibility when diagnosing and treating people presenting with symptoms of panic,” said Dr Walters.

Walters K, Rait G, Petersen I, Williams R, Nazareth I. Panic disorder and risk of new onset coronary heart disease, acute myocardial infarction, and cardiac mortality: cohort study using the general practice research database. European Heart Journal. 2008;29:2981-2988. doi:10.1093/eurheartj/ehn477.

News release: Panic attacks linked to higher risk of heart attacks and heart disease, especially in younger people. European Society of Cardiology. December 10th 2008.

Study results have shown that people with depression are at increased risk of heart attack and heart failure because they are less likely to be active.

Scientists have known for some years that people who are depressed are at increased risk of heart attack and other cardiac events, however the reason why this should be has remained unclear. However, according to results of a study by Mary A Wooley and colleagues, the increased risk is due to behavioral factors.

The researchers analyzed data obtained from 1,017 people with heart disease, 199 of which had symptoms of depression. Results showed that 10% of depressed participants had a cardiac event (e.g. heart attack, heart failure, stroke, transient ischemic attack) during the study period, compared to just 6.7% of non-depressed participants, meaning that depressed participants were 50% more likely to have a cardiac event. However, results also showed that depressed participants were more likely to smoke, were less likely to take their medications as prescribed, and were less physically active. After the researchers factored these behaviors into their calculations the risk of a cardiac event in depressed participants was similar to that in non-depressed participants.

The researchers concluded: “These findings raise the hypothesis that the increased risk of cardiovascular events associated with depression could potentially be preventable with behavior modification, especially exercise.” Adding: “Exercise training can improve both depressive symptoms and markers for cardiovascular risk.”

Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 2008;300:2379-2388.

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All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight