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(Ivanhoe Newswire) -- Heart disease patients with anxiety have twice the risk of dying compared to those without anxiety and patients with anxiety and depression triple their risk of dying.

"Many studies have linked depression to an increased risk of death in heart disease patients," Lana Watkins, Ph.D., lead author of the study and an associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center in Durham, N.C, was quoted as saying. "However, anxiety hasn't received as much attention."
934 heart disease patients, average age 62, completed a questionnaire measuring their level of anxiety and depression immediately before or after a cardiac catheterization procedure at Duke University Medical Center.

Patients had anxiety if they scored 8 or higher on a scale composed of seven common characteristics of anxiety, with each item rated from 0 to 3 (range of possible scores: 0-21). Depression was measured using a similar scale composed of seven symptoms of depression.

After accounting for age, congestive heart failure, kidney disease and other factors that affect death risk, researchers found 90 of the 934 patients experienced anxiety only, 65 experienced depression only and 99 suffered anxiety and depression. Among 133 patients who died during three years of follow-up, 55 had anxiety, depression or both. The majority of deaths (93 of 133) were heart-related.

"Future studies should test strategies to manage anxiety alone and with depression in heart disease patients," Watkins said.

"Anxiety reducing medications combined with stress management could improve outcome for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention involving more frequent outpatient monitoring and incentives to improve adherence," she said.

SOURCE: American Heart Association Rapid Access Journal, March 2013