Anxiety and Risk of Incident Coronary Heart Disease: A Meta-Analysis

Objectives The purpose of this study was to assess the association between anxiety and risk of coronary heart disease (CHD). Background Less research has focused on the association of anxiety with incident CHD in contrast to other negative emotions, such as depression. Methods A meta-analysis of references derived from PubMed, EMBASE, and PsycINFO (1980 to May 2009) was performed without language restrictions. End points were cardiac death, myocardial infarction (MI), and cardiac events. The authors selected prospective studies of (nonpsychiatric) cohorts of initially healthy persons in which anxiety was assessed at baseline. Results Twenty studies reporting on incident CHD comprised 249,846 persons with a mean follow-up period of 11.2 years. Anxious persons were at risk of CHD (hazard ratio [HR] random: 1.26; 95% confidence interval [CI]: 1.15 to 1.38; p