Look out for potential coronary heart disease (CHD) in older women who have experienced panic attacks, a recent study urges. They face substantially higher risks of MI, stroke, and death.

Almost 10% of 3,369 healthy postmenopausal women reported at least one “full-blown” panic attack within six months of the research baseline. That proportion confirmed earlier studies, which showed that panic attacks are not unusual among this group.

Over the next five years, these women were four times more likely to have an MI, three times more likely to develop either CHD or stroke, and almost twice as likely to die of a noncoronary cause as women who had not reported panic attacks. The ratios were independent of other CHD risk factors, including BMI, smoking, hypertension, depression, diabetes, and history of heart disease.

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“Results suggest panic anxiety is a marker for increased cardiovascular (CV) morbidity and mortality among postmenopausal women,” the authors concluded. “Careful monitoring and CV risk reduction may be particularly important.”

Led by Jordan W. Smoller, MD, ScD, of Massachusetts General Hospital in Boston, the researchers defined “full-blown” panic attacks as sudden fear or anxiety combined with four or more other symptoms. These included rapid heartbeat, trembling, smothering or shortness of breath, and lightheadedness (Arch Gen Psychiatry. 2007;64:1153-1160).

Participants reported their panic attacks by answering a questionnaire that listed symptoms in lay terms. “It is possible that [these] were in fact episodes of ischemia or arrhythmia,” the researchers noted. “If so, self-reported panic attacks might represent a marker of underlying CV disease that may presage MI or stroke.”