Author + information
- Received February 5, 2007
- Revision received August 20, 2007
- Accepted September 7, 2007
- Published online January 15, 2008.
- Biing-Jiun Shen, PhD⁎,⁎ (, )
- Yael E. Avivi, MS†,
- John F. Todaro, PhD‡,
- Avron Spiro III, PhD§,
- Jean-Philippe Laurenceau, PhD∥,
- Kenneth D. Ward, PhD# and
- Raymond Niaura, PhD¶
- ↵⁎Reprint requests and correspondence:
Dr. Biing-Jiun Shen, Assistant Professor, Department of Psychology, University of Southern California, 3620 South McClintock Avenue, Los Angeles, California 90089-1061.
Objectives This study investigated whether anxiety characteristics independently predicted the onset of myocardial infarction (MI) over an average of 12.4 years and whether this relationship was independent of other psychologic variables and risk factors.
Background Although several psychosocial factors have been associated with risk for MI, anxiety has not been examined extensively. Earlier studies also rarely addressed whether the association between a psychologic variable and MI was specific and independent of other psychosocial correlates.
Methods Participants were 735 older men (mean age 60 years) without a history of coronary disease or diabetes at baseline from the Normative Aging Study. Anxiety characteristics were assessed with 4 scales (psychasthenia, social introversion, phobia, and manifest anxiety) and an overall anxiety factor derived from these scales.
Results Anxiety characteristics independently and prospectively predicted MI incidence after controlling for age, education, marital status, fasting glucose, body mass index, high-density lipoprotein cholesterol, and systolic blood pressure in proportional hazards models. The adjusted relative risk (95% confidence interval [CI]) of MI associated with each standard deviation increase in anxiety variable was 1.37 (95% CI 1.12 to 1.68) for psychasthenia, 1.31 (95% CI 1.05 to 1.63) for social introversion, 1.36 (95% CI 1.10 to 1.68) for phobia, 1.42 (95% CI 1.14 to 1.76) for manifest anxiety, and 1.43 (95% CI 1.17 to 1.75) for overall anxiety. These relationships remained significant after further adjusting for health behaviors (drinking, smoking, and caloric intake), medications for hypertension, high cholesterol, and diabetes during follow-up and additional psychologic variables (depression, type A behavior, hostility, anger, and negative emotion).
Conclusions Anxiety-prone dispositions appear to be a robust and independent risk factor of MI among older men.
Supported by a grant from the American Heart Association and an award from the National Alliance for Research on Schizophrenia and Depression.
- Received February 5, 2007.
- Revision received August 20, 2007.
- Accepted September 7, 2007.
- American College of Cardiology Foundation