Why it’s no surprise that hypochondriacs get more heart disease

Hypochondriacs are more likely to develop heart disease, according to research at the University of Bergen in Norway.

The ‘worried well’ were 73 per cent more likely to develop heart disease than those who are not anxious about their health.

The link may be explained by the fact that stress of any kind has long been recognised as a risk factor for the disease.

During the study, published in the journal BMJ Open, the researchers examined health data from more than 7,000 people born in Norway in the 1950s. The participants’ heart health was tracked using national data on hospital treatment for heart conditions. Their anxiety was measured using a standard scale.

By 2009, 234 people in the group had experienced acute angina or myocardial infarction (a heart attack). The researchers said they were unable to establish a causal relationship between anxiety and heart disease, and that people with anxiety were more likely to have other mental health problems which could contribute to poor health.

The researchers wrote: ‘These findings illustrate the dilemma for clinicians between reassuring the patient that current physical symptoms of anxiety do not represent heart disease, contrasted against the emerging knowledge on how anxiety, over time, may be causally associated with increased risk of coronary artery disease.

‘Our research indicates that characteristic behaviour among persons with health anxiety, such as monitoring and frequent check-ups of symptoms, does not reduce the risk of coronary heart disease events.’

Instant analysis
This study was a prospective cohort study examining the relationship between health anxiety (determined by validated questionnaire) and the development of coronary heart disease (defined as heart disease leading to angina or a heart attack). Studies like this do not establish causation but usually highlight correlation.

During the seven-year follow-up period, double the number of people with health anxiety experienced a cardiac event compared to those without (6.1 per cent versus three per cent). After analysis, men and women with anxiety were almost twice as likely to develop coronary heart disease, with the effect more pronounced in men, even after adjusting for risk factors.

The results are consistent with previous data suggesting stress is an important risk factor for heart disease; anxiety about health is also a form of stress, and so it should come as no surprise that this relationship was found.

What would have been interesting is if the activities of those patients most at risk had been tracked. Did their health anxiety translate into ‘heart-healthy’ activities? Did they attempt to make positive lifestyle changes in order to alleviate risk?

Take-home message: mental health is as important as physical health.
TSA
Research score: 3/5