Highlights

02.03.2018

Female patients with anxiety disorder react more quickly to a heart attack

Fear protects people from danger. A team from Helmholtz Zentrum München and the Technical University of Munich (TUM) has discovered that this applies even to pathological anxiety disorders. Patients who generally suffer from severe anxiety are likely to heed the symptoms of a heart attack earlier and seek medical treatment sooner, thus improving their chance of survival. The study was published in ‘Clinical Research in Cardiology’.

© Fotolia/Peshkova

People with anxiety disorder have irrational fears that are unrelated to any real danger. They are often apprehensive about everyday situations, which can put a heavy strain on their lives. The result can be an increased risk for cardiovascular diseases. However, since time immemorial fear has also served as an effective protective mechanism in acute emergencies. A team headed by Professor Karl-Heinz Ladwig of Helmholtz Zentrum München and the TUM has now discovered that even anxiety disorders can be advantageous when it comes to reacting to a heart attack. 

For the study they made use of data from the MEDEA study (Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction), in which 619 heart-attack patients were interviewed in hospital within 24 hours of leaving the intensive care unit, as well as other data such as the time of arrival at the hospital and the course of the disease.

In hospital two hours earlier

Prompt drug treatment after a heart attack reduces damage to the heart, subsequent health impairment and the likelihood of death. 

About 12 percent of the patients in the study had anxiety disorder. It turned out that those patients reacted more quickly to an acute heart attack and arrived at the emergency room sooner. The time difference between female heart attack patients with and without anxiety disorder was particularly marked: on average, the former reached a hospital 112 minutes after the onset of a heart attack, while their counterparts without anxiety disorder took around two hours longer. Many scientific studies have shown that every half hour is crucial for survival following an acute myocardial infarction, Karl-Heinz Ladwig explains. 

The team was, however, only able to statistically demonstrate the protective effect of anxiety in women, not in men. Nevertheless, a positive trend was also observed in men with anxiety disorder: they were able to be treated 48 minutes earlier on average.

More sensitive to their own health

“Individuals with anxiety disorder are at greater risk of having a heart attack but are more likely to survive it. Our data revealed an important factor,” explains Karl-Heinz Ladwig. “Individuals with anxiety disorder often react more sensitively to their health needs,” he adds. “Doctors should always take their concerns very seriously. Such patients are also more decisive when it comes to accepting help. In this way, one illness can help protect against another serious illness.”

Nevertheless, as the study also showed, the psychological costs of this survival advantage are high: patients with anxiety disorder suffer significantly more from stress, extreme fatigue and impaired general well-being than those without anxiety. In future studies, the researchers want to investigate the role of cultural differences and are planning a similar study in Shanghai.


Further information

Background:
The MEDEA study is co-funded by the German Heart Foundation and is being realized as part of the Munich Heart Alliance.

Original Publication:
Fang X. Y. et al. (2018): Impact of generalized anxiety disorder (GAD) on prehospital delay of acute myocardial infarction patients. Findings from the multicenter MEDEA study. Clinical Research in Cardiology, DOI: 10.1007/s00392-018-1208-4

Scientific Contact:
Prof. Dr. Karl-Heinz Ladwig
Helmholtz Zentrum München - German Research Center for Environmental Health
Institute of Epidemiology
Ingolstädter Landstr. 1
D-85764 Neuherberg
tel. +49 89 3187 3623


As German Research Center for Environmental Health, Helmholtz Zentrum München pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes mellitus and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München has about 2,300 staff members and is headquartered in Neuherberg in the north of Munich. Helmholtz Zentrum München is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members.

The Institute of Epidemiology (EPI) assesses genetic, environmental and lifestyle risk factors which jointly determine the occurrence of major chronic diseases. The focus is on the development and progression of metabolic, respiratory and allergic diseases, as well as heart diseases and mental health. The goal is to understand the molecular underpinning of disease better and to translate this knowledge into personalized approaches of prevention as well as polices to improve health. Research builds on the unique resources of the KORA cohort, the KORA myocardial infarction registry, and the KORA aerosol measurement station. Aging-related phenotypes have been added to the KORA research portfolio within the frame of the Research Consortium KORA-Age. Moreover, the institute makes use of the birth cohorts GINI and LISA. It plays a leading role in the planning and setting up of the German National Cohort and builds the NAKO biorepository.

Technical University of Munich (TUM) is one of Europe’s leading research universities, with more than 500 professors, around 10,000 academic and non-academic staff, and 40,000 students. Its focus areas are the engineering sciences, natural sciences, life sciences and medicine, com-bined with economic and social sciences. TUM acts as an entrepreneurial university that promotes talents and creates value for society. In that it profits from having strong partners in science and industry. It is represented worldwide with a campus in Singapore as well as offices in Beijing, Brussels, Cairo, Mumbai, San Francisco, and São Paulo. Nobel Prize winners and inventors such as Rudolf Diesel, Carl von Linde, and Rudolf Mößbauer have done research at TUM. In 2006 and 2012 it won recognition as a German "Excellence University." In international rankings, TUM regularly places among the best universities in Germany.