Longstanding anxiety markedly increases the risk of heart attack, even when other common risk factors are taken into account, according to Biing-Jiun Shen, assistant professor of psychology in USC College.

“Older men with sustained and pervasive anxiety appear to be at increased risk for a heart attack over and beyond what can be explained by other cardiovascular risk factors,” said Shen, who joined the College faculty in 2007.

The research is published in the Jan. 15 issue of the Journal of the American College of Cardiology.

The risk from anxiety was independent of the more accepted biomedical factors associated with heart attacks — such as age, obesity, glucose, cholesterols, blood pressure and smoking — as well as other psychological factors, including depression, anger, hostility and Type A behavior, Shen said.

“The physiological reactions of anxiety are very similar to signs and changes that are thought to lead to myocardial infarctions,” Shen said. “Look at what happens when you are anxious. Your body reacts as if it is in danger. It is the flight or fight response. The reactions are very similar to those brought on by anger or a Type A personality that have been observed in earlier research.”

Although many may think of anxiety as intense worry and tension, Shen also examined excessive doubts, obsessive thoughts, irrational compulsions, insecurity, discomfort in social situations and phobias.

“The good thing about anxiety is that it’s very treatable,” Shen said. “If someone is highly anxious — if they’re suffering from panic attacks or social phobia or constant worry — we recommend therapy. Although more research is needed, we hope that by reducing anxiety, we can lower the future risk of heart attack. This is one more reason to seek help.”

For the study, Shen and his colleagues analyzed data from the Normative Aging Study, which was designed to assess medical and psychological changes associated with aging among a group of initially healthy men.

Each of the 735 men participating in the new analysis completed psychological testing in 1986 and was in good cardiovascular health at the time.

Separate sections of the psychological test measured hostility, anger, Type A behavior, depression and negative emotions. Study participants also completed questionnaires about health habits such as smoking, alcohol consumption and daily diet. They had a medical exam every three years over a follow-up period that averaged more than 12 years.

The investigators found that men who tested at the highest 15th percentile on any of the four anxiety scales, as well as on a scale combining all four, faced an increase in the risk of heart attack of approximately 30 to 40 percent.

Shen worked on the study with several colleagues, including Yael Avivi of the University of Miami and co-authors Avron Spiro of Boston University and Raymond Niaura of Brown Medical School.

Shen said the new research does not address the role of anxiety in provoking heart attacks in women. He and his colleagues are considering such a study in the future.

Shen was supported by a grant from the American Heart Association and an award from the National Alliance for Research on Schizophrenia and Depression.