Those Type A go-getters aren't the only ones stressing their hearts. Nervous Nelsons seem to be, too. Researchers reported Monday that chronic anxiety can significantly increase the risk of a heart attack, at least in men. The findings add another trait to a growing list of psychological profiles linked to heart disease, including anger or hostility, Type A behavior, and depression.
"There's a connection between the heart and head," said Dr. Nieca Goldberg of the New York University School of Medicine, a spokeswoman for the American Heart Association who wasn't involved in the study.
"This is very important research because we really are focused very much on prescribing medicine for cholesterol and lowering blood pressure and treating diabetes, but we don't look at the psychological aspect of a patient's care," she added. Doctors "need to be aggressive about not only taking care of the traditional risk factors ... but also really getting into their patients' heads."
The research was published Monday by the Journal of the American College of Cardiology.
Everybody's anxious every now and then. At issue here is not the understandable sweaty palms before a big speech or nervousness at a party, but longstanding anxiety — people who are socially withdrawn, fearful, chronic worriers. It's a glass-half-empty personality.
University of Southern California psychologist Biing-Jiun Shen used data from a national aging study to estimate the impact of this trait on the heart.
The Normative Aging Study has tracked 735 men since 1986. They were heart-healthy at the study's start, have completed extensive psychological testing, and undergo medical exams every three years. By 2004, there had been 75 heart attacks among the participants.
Shen tracked men who scored in the top 15 percent of anxiety scales that measure such things as excessive doubts, social insecurity, phobias and stress.
Those men deemed chronically anxious were 30 percent to 40 percent more likely to have had a heart attack than their more easygoing counterparts.
The link remained even when Shen took into account standard heart risk factors such as cholesterol problems, as well as other heart-negative personality traits.
Why? After all, a hostile person and an anxious one appear very different, one outgoing and one timid.
"Although the behavior is quite different ... if you look at the physiological response of these people, they're quite similar," Shen said. "All have raised blood pressure, heart rate, they produce more stress hormones."
So, would treating anxiety lower the risk? No one knows, cautioned NYU's Goldberg. That's why these personality traits are considered "markers" for heart disease, not outright "risk factors" like cholesterol or blood pressure.