Anxiety disorders raise the risk of heart attack, stroke, heart failure and death in people with heart disease.

Anxiety is common in patients with heart disease, but studies examining the effect of anxiety on cardiovascular prognosis have yielded inconsistent results. To evaluate the effect of generalized anxiety disorder on heart disease, researchers followed 1,015 Americans with stable coronary heart disease who were assessed for anxiety disorder through diagnostic interviews at the start of the study and then followed for almost six years.

During the follow-up, there were a total of 371 cardiovascular events (heart attacks or other incidents that may cause damage to the heart). The yearly rate of cardiovascular events was almost 10 percent among the 106 patients with generalised anxiety disorder and 7 percent among the other 909 patients.

After adjusting for a number of factors - such as other health problems, heart disease severity and medication use - it was found that generalised anxiety disorder was associated with a 75 percent higher risk of cardiovascular events.

The researchers attributed the association between anxiety and heart trouble to many factors. Anxiety may be linked with surges in "fight or flight" hormones called catecholamines that may be related to heart risk, or people with anxiety may be more likely to seek medical care when they have symptoms of a cardiovascular event. It's also possible that a common underlying factor may increase the risk of both anxiety and heart events.