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High Anxiety Levels May Increase Long-Term Risk of Stroke, Pitt Study Finds

PITTSBURGH, December 19, 2013 – People with high levels of anxiety may be at an increased risk for stroke, according to a new study published today in the journal Stroke.  Researchers from the University of Pittsburgh evaluated more than 6,000 participants and found those with the highest levels of anxiety are 33 percent more likely to suffer a stroke, as compared to their less anxious counterparts.
Previous studies have found that higher levels of anxiety are associated with increased risk for coronary heart disease; few studies have investigated the connection between anxiety and stroke.  This study is the first to report an association between higher anxiety symptoms and an increased risk for stroke, despite other risk factors such as depression.
“Anxiety is a very common condition in the general population, but it’s also a modifiable behavior,” said Maya Lambiase, Ph.D., post-doctoral scholar in the Department of Psychiatry at the University of Pittsburgh School of Medicine and lead author of the report. “Assessment and treatment of anxiety has the potential to not only improve overall quality of life, but also reduce the risk of cardiovascular diseases, such as stroke, later in life.”
Anxiety disorders affect nearly 20 percent of American adults in any given year, and are characterized by feelings of fear, unease and worry, often lasting at least six months.  Feelings of stress and anxiety are also common in people who feel depressed or have other mental health problems, including alcohol or substance abuse.  Stroke, which occurs when blood flow to a part of the brain stops, is the number four killer and a leading cause of disability in the U.S.
“Most of the focus up until this point has been on depression. These findings underscore the importance of also considering anxiety when considering cardiovascular diseases,” noted Rebecca Thurston, Ph.D., associate professor of psychiatry at Pitt and co-author of the study. “These findings encourage practitioners to assess and treat anxiety, as well as to reconsider popular notions such as ‘worried well’ – this worrying may not make us so well.”
Researchers studied people aged 25 to 74 who had not experienced a stroke and were representative of the general U.S. population. All participants were enrolled in the National Health and Nutrition Examination Survey (NHANES), which collected data from 1971-1975. Participants filled out a questionnaire that measured anxiety and depression levels, and were then followed for a period of up to 22 years.  Researchers tracked stroke occurrences in these people through death certificates as well as hospital and nursing home reports. 
“Even a modest increase in anxiety was associated with an increase in stroke risk, so greater education and awareness of anxiety management is important,” added Lambiase. The researchers also noted that people with high anxiety levels are more likely to smoke and be physically inactive which may help explain part of the anxiety-stroke link. 
Co-authors on this study include Laura D, Kubzansky, Ph.D., of the Harvard School of Public Health, and Rebecca C. Thurston, Ph.D., of the University of Pittsburgh.
This study was funded by the National Heart, Lung, and Blood Institute (HL07560) and the National Institute of Mental Health (MH092707-01) of the National Institutes of Health. 

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