An article published in the October 2007 issue of Archives of General Psychiatry suggests that older women who experience panic attacks may be at increased risk of having a heart attack or stroke and at increased risk of death over the next five years. MGH researcher Jordan W. Smoller, M.D. and colleagues followed 3,369 healthy postmenopausal women as part of the Women’s Health Initiative. Upon entry into the study, participants filled out a questionnaire about the occurrence of panic attacks in the previous six months and were then followed prospectively for an average of 5.3 years to assess risk for cardiovascular disease. About 10 percent of the women reported having a full-blown panic attack in the six months prior to the study.

In an ancillary study of the Women’s Health Initiative, Smoller et al. found that postmenopausal women reporting a 6-month history of panic attack had 4-fold increased odds of coronary heart disease, 3-fold increased odds of stroke, and 75% increased odds of all-cause mortality during prospective follow-up. The increased risks, observed after controlling for potential confounders, suggest that panic attacks are an independent risk factor for cardiovascular morbidity and mortality in older women.

The authors point out that the study was not designed to evaluate the nature of the link between panic attacks and cardiovascular disease. They speculate that panic attacks may trigger heart rhythm abnormalities or that stress hormones released during an attack may negatively affect the heart.

Ruta Nonacs, MD PhD

Smoller et al. Panic Attacks and Risk of Incident Cardiovascular Events Among Postmenopausal Women in the Women’s Health Initiative Observational Study. Arch Gen Psychiatry 2007;64:1153-1160.

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