Panic disorder and cardiovascular diseases: an overview

Sergio Machado, Federica Sancassiani, Flavia Paes, Nuno Rocha, Eric Murillo-Rodriguez, Antonio Egidio Nardi

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

The association between panic disorder (PD) and cardiovascular diseases (CVD) has been extensively studied in recent years and, although some studies have shown anxiety disorders co-existing or increasing the risk of heart disease, no causal hypothesis has been well established. Thus, a critical review was performed of the studies that evaluated the association between PD and cardiovascular diseases; synthesizing the evidence on the mechanisms mediators that theoretically would be the responsible for the causal pathway between PD and CVD, specifically. This overview shows epidemiological studies, and discusses biological mechanisms that could link PD to CVD, such as pleiotropy, heart rate variability, unhealthy lifestyle, atherosclerosis, mental stress, and myocardial perfusion defects. This study tried to provide a comprehensive narrative synthesis of previously published information regarding PD and CVD and open new possibilities of clinical management and pathophysiological understanding. Some epidemiological studies have indicated that PD could be a risk factor for CVD, raising morbidity and mortality in PD, suggesting an association between them. These studies argue that PD pathophysiology could cause or potentiate CVD. However, there is no evidence in favour of a causal relationship between PD and CVD. Therefore, PD patients with suspicions of cardiovascular symptoms need redoubled attention.

Original languageEnglish
Pages (from-to)436-444
Number of pages9
JournalInternational Review of Psychiatry
Volume29
Issue number5
DOIs
StatePublished - 3 Sep 2017

Keywords

  • cardiovascular disease
  • heart rate variability
  • Panic disorder
  • pleiotropy
  • unhealthy lifestyle and atherosclerosis

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