Declaration of interest
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.
To determine and examine the independent association and causality between anxiety and incident CVD.
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.
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.
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.
B.W.J.H.P. is supported by an NWO-VICI grant 91811602.
- © The Royal College of Psychiatrists 2016.
Log in using your username and password
Log in through your institution
Purchase Short-Term Access
Pay per Article - You may access this article (and download the PDF version) for 1 day for US$30.00.
Pay per Issue - You may access this issue (from the computer you are currently using) for 365 days for US$90.00.
Pay for Admission - You may access all content in The British Journal of Psychiatry (and download the PDF version) for 1 day for US$45.00.
Regain Access - You can regain access to a recent Pay per Article, Pay per Issue, or Pay for Admission purchase if your access period has not yet expired.