Panic attacks linked to higher risk of heart attacks and heart disease, especially in younger people

People who have been diagnosed with panic attacks or panic disorder have a greater risk of subsequently developing heart disease or suffering a heart attack than the normal population, with higher rates occurring in younger people, according to research published in Europe's leading cardiology journal, the European Heart Journal [1] today (Thursday 11 December).

The study found that people who were younger than 50 when first diagnosed had a significantly higher risk of subsequent heart attacks (or myocardial infarctions, MI), but this was not the case in older people. It also found there was a significantly higher incidence of subsequent coronary heart disease (CHD) in people diagnosed with panic attacks/disorder at all ages, but this was more marked in the under 50s.

However, the research also showed that the risk of dying from CHD was actually reduced amongst people of all ages who had been diagnosed with panic attacks/disorder.

The study is the first to look at a very large sample of the UK population of all ages (a total of 404,654 people) selected from a primary care population that can be broadly generalised to other countries with a similar socio-demographic structure. It is also the first to identify that the higher risk of heart attacks with panic attacks/disorder is mainly in younger people (aged under 50 years), and that having a panic attacks/disorder diagnosis is associated with a lower risk of dying from heart conditions.

Dr Kate Walters, a senior lecturer in primary care at University College London (UK), who led the research, said: "Not much is known about the relationship between panic disorder and cardiac disease. The symptoms of panic attacks can closely mimic those of a heart attack or acute cardiac disease, and it seems that there may be a complex relationship between them.

"Our findings have significant implications for clinicians. Panic attacks were associated with a significant increased risk of a subsequent diagnosis of CHD and acute MI in those aged younger than 50. This may be due to initial misdiagnosis of CHD as panic attacks, or a true underlying increased risk of CHD with panic attacks. Clinicians should be vigilant for this possibility when diagnosing and treating people presenting with symptoms of panic."

Dr Walters and her colleagues looked at primary care medical records for 57,615 adults diagnosed with panic attacks/disorder and 347,039 adults who did not have the condition. They found that those aged under 50 were more than a third (38%) as likely to have a heart attack and nearly half (44%) as likely to develop heart disease subsequently than people who had not been diagnosed with the condition. For people aged over 50 there was a slightly increased risk of heart disease (11%).

However, when the researchers looked at deaths amongst adults diagnosed with panic attacks/disorder, they found that for all ages the risk of death from heart disease was reduced by about a quarter (24%) compared with the normal population.