Anxiety Ups Death Risk in Heart Failure Patients

"Until we have that understanding of the mechanisms that connect worsening of mood and poor outcomes, it will be hard to develop interventions," Januzzi said.

He's currently working on identifying biomarkers of risk, such as inflammation and injury to the heart muscle, and then relating them to feelings such as anxiety and depression.

"We have found some interesting results," Januzzi said. "We can see a clear signal emerging, using measures of heart dysfunction. In doing so, we may be able to identify a target for treatment."

What seems plain is that "the era of 'it's all in your head' is over," Januzzi said. "There is an intimate connection between the neurovascular and cardiac system that remains unexplored as yet. Patients with anxiety and depression shouldn't feel stigmatized. There are real effects on organ systems other than the heart."

Another report in the same issue of the journal found a significantly increased risk of death in people with heart failure who also had sleep apnea. The study of 88 people with heart failure found an average survival time of 45 months for those with sleep apnea, defined as five or more breathing interruptions per hour, and 90 months for those without the breathing disorder.

The study, described as the largest of its kind, was done at the Cincinnati Veterans Affairs Medical Center and the University of Cincinnati College of Medicine.

More information

There's more on anxiety disorders at the U.S. National Institute of Mental Health.

SOURCES: Charles M. Blatt, M.D., director, research, Lown Cardiovascular Research Foundation, Boston; James L. Januzzi, M.D., director, cardiac intensive care unit, Massachusetts General Hospital, Boston; May 22, 2007,Journal of the American College of Cardiology