Is Worrying About Your Health Bad for Your Heart?

Wednesday, 16 November 2016

A study of 7052 participants in Norway looked at whether hypochondria (also known as health anxiety) was associated with the onset of heart disease.

The Hordaland Health Study (HUSK) invited everyone living in Hordaland, Norway, who were born between 1953 and 58, to fill in a questionnaire. The participants also had a physical examination, during which their weight, height and blood pressure were measured and blood samples were taken.

The participants answered questions about their health concerns, and their heart health was monitored over a 12-year period. The results showed that people with hypochondria had a 73% higher chance of developing heart disease than those without. Anxiety was monitored by a self-report scale known as The Whitley Index. It includes 14 questions that cover concerns and fears about being unwell.

To identify cases of heart disease, the researchers linked the participants with the CVDNOR (Cardiovascular Diseases in Norway) study, which collected data on all hospitalisations and deaths from heart disease in the country between 1994 and 2009.

The researchers adjusted their analysis for a number of confounding factors that were assessed in the examinations and questionnaires. These included age, gender, educational level, marital status, BMI, physical activity, smoking, alcohol, blood pressure, diabetes and cholesterol. They excluded anyone who had had heart disease before enrolling on the study, or anyone who developed it within the first follow-up year.

Of the sample left over, 10 percent of participants met the criteria for having hypochondria. 3.3 percent of the participants on average developed heart disease after seven follow-up years, but the rate was higher among those with hypochondria.

Prospective cohort studies like this one are considered the best way to find out whether a certain factor is associated with a longer-term health result. But it’s not easy to account fully for all the variables that could be involved, especially with subjective factors like anxiety or worry.

But it’s hard to say with certainty that hypochondria is a direct and independent risk factor for the increase of heart disease.

The researchers considered other heart disease risk factors, including smoking, cholesterol, obesity, blood pressure and diabetes, but did not look at the participants’ health in any more detail. The possibility that these health factors might have contributed to both the heart disease risk and their health concerns can’t be ruled out.

However, the study does highlight that like other mental health problems, anxiety can have an impact on your physical health and previous studies have suggested that anxiety is a risk factor for heart disease.