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• Posted January 24, 2022

Worries May Raise Men's Heart Risks, Even When Young

Worrying can take a toll on your psyche, but new research suggests that when middle-aged men fret too much, they face a higher risk for developing diabetes, heart disease or stroke down the road.

And this increase in risk is on par with the health risks linked to heavy drinking, the findings showed.

"Our findings suggest that anxiety is linked to unhealthy biological processes that pave the way to developing heart disease and diabetes in men," said study author Lewina Lee. She is an assistant professor of psychiatry at Boston University School of Medicine and a clinical research psychologist at the National Center for Post-traumatic Stress Disorder of the VA Boston Healthcare System.

Taking steps to improve mental health may help lower risks for heart disease and diabetes, Lee added.

The study included more than 1,550 men (aged 53, on average), who took part in the Normative Aging Study. These men didn't have any major diseases at the beginning of the study. The researchers looked at seven biological risk factors -- including blood pressure, cholesterol, blood fats known as triglycerides, body mass index, blood sugar and a marker for inflammation -- every three to five years until the men died or dropped out of the study.

A risk was considered elevated if the test results were higher than cut-off points in national guidelines, or the men were taking medication to control it. Men received one point for each elevated risk factor. They also answered standard questionnaires that measure anxiety and worry when the study began.

Men who reported higher levels of anxiety had a 10% to 13% greater chance of reaching high biological risk for heart disease, stroke or diabetes during the 40-year follow-up period, the researchers found.

The study wasn't designed to say how worry and anxiety increase risks for disease, but worriers were more likely to smoke, consume alcohol and not exercise regularly.

"Psychosocial factors related to anxiety, such as a stronger tendency to interpret even neutral situations as stressful or to avoid uncomfortable situations, may mean that anxious individuals are less adept in coping with stressors and at greater risk for poor mental health in general, which can, in turn, increase disease risk," Lee said.

Anxious men had a greater number of high-risk factors at all ages, and these findings held even after researchers controlled for other known risks for heart disease, such as family history.

These risks preceded the diagnosis of any disease, suggesting a window of opportunity for prevention, Lee said. For example, it's possible to catch blood pressure as it starts creeping up and intervene with lifestyle changes before it turns into full-fledged high blood pressure.

The study did have its share of limitations. The researchers didn't have data on whether men were diagnosed with an anxiety disorder. In addition, participants were all male and nearly all white, so the findings may not be generalizable to other groups.

The report was published online Jan. 24 in the Journal of the American Heart Association.

Two experts who were not involved with the study agreed that the new findings highlight the importance of leading a healthy lifestyle.

"Negative psychological health, such as anxiety, can lead persons to detrimental lifestyle practices, such as poor eating, lack of exercise, not taking medications, and not following up on health checks," said Dr. Glenn Levine, chief of the cardiology section at the Michael E. DeBakey VA Medical Center in Houston. "It may also long-term have some more direct adverse physiological effects on the heart and body."

But this doesn't mean you're powerless.

"Pay a little more attention to things like being overweight, healthy eating, checking that blood pressure is not elevated or [if on medicines] well-controlled, and taking all prescribed medicines to lower cholesterol and blood pressure levels," Levine said.

Dr. Howard Weintraub added, "This is a very interesting and thought-provoking article that makes us remember that our health can be influenced by our emotional state." Weintraub is clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health in New York City. "If you are neurotic and worry a lot, you likely won't pay close attention to lifestyle factors that affect risk for heart disease, diabetes and stroke."

The good news is that some of the things that help lower your risk for heart disease, such as regular exercise, can also have spillover benefits for your mental health, Weintraub said.

More information

The American Heart Association offers tips on how to prevent heart disease at any age.

SOURCES: Lewina Lee, PhD, assistant professor, psychiatry, Boston University School of Medicine, and clinical research psychologist, National Center for Post-traumatic Stress Disorder, VA Boston Healthcare System; Glenn Levine, MD, professor, medicine, Baylor College of Medicine, and chief, cardiology section, Michael E. DeBakey VA Medical Center, Houston; Howard Weintraub, MD, cardiologist, clinical director, Center for the Prevention of Cardiovascular Disease, NYU Langone Health, New York City; Journal of the American Heart Association, Jan. 24, 2022, online