According to recent research, there’s a definite connection between panic attacks and heart attacks. What that connection is, however, remains open to additional research.

Smoller and his colleagues (2007) decided to see whether panic attacks are associated with a greater risk of either a heart attack or stroke in older women.

They examined data from 10 clinical centers of the large 40-center Women’s Health Initiative. The study looked at a total of 3369 generally-healthy postmenopausal women (aged 51-83 years) enrolled between 1997 and 2000 in the Myocardial Ischemia and Migraine Study who completed a questionnaire about occurrence of panic attacks in the previous 6 months. Then they looked at all cardiovascular events, including those that resulted in a person’s death.

The researchers defined full-blown panic attacks as sudden fear, anxiety, or extreme discomfort accompanied by four or more DSM-defined panic attack symptoms. A total of 330 patients reported experiencing full-blown panic attacks over the 6 months before the study, and 273 had experienced limited-symptom panic attacks (anxiety plus 1–3 panic attack symptoms).

Researchers determined the possible risk for coronary heart disease after adjustment for all relevant risk factors, including smoking, hypertension, body-mass index, depression history, and physical activity. The risk for subsequent heart disease was over 4 times higher, and over 3 times higher for stroke, in women who had experienced full-blown panic attacks than in those without panic histories, but not in women who didn’t have full-blown panic attacks but merely symptoms of anxiety. Depression was not associated with cardiovascular events after adjustment for panic attacks.

The researchers determined that panic attacks are relatively common among postmenopausal women. They also appear to be an independent risk factor for cardiovascular morbidity and mortality in older women. This doesn’t mean panic attacks can cause a heart attack (because it could be that women with pre-existing or genetic heart conditions are more predisposed to panic symptoms), but it does mean that if a woman has a history of full-blow panic attacks, they will be at greater risk for coronary heart disease and stroke. Such women should likely be more closely monitored by their physician for these health issues.

Reference: Smoller JW et al. (2007). Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women’s Health Initiative Observational Study. Arch Gen Psychiatry, 64:1153.