A study published on January 24 in the Journal of the American Heart Association found that middle-aged men who reported more feelings of worry or feeling overwhelmed may be at greater biological risk for developing cardiometabolic disease as they get older. “While the participants were primarily white men, our findings indicate higher levels of anxiousness or worry among men are linked to biological processes that may give rise to heart disease and metabolic conditions, and these associations may be present much earlier in life than is commonly appreciated — potentially during childhood or young adulthood,” said Lewina Lee, PhD, lead author of the study, an assistant professor of psychiatry at Boston University School of Medicine, and an investigator and clinical psychologist at the National Center for Post-Traumatic Stress Disorder at the U.S. Department of Veterans Affairs, both in Boston, in an AHA release.
Worry Can Be Helpful, but Not When It Interferes With Day-To-Day Functioning
To explore the relationship between anxiety and heart-disease risk factors over time, researchers used data from 1,571 men who took part in the Normative Aging Study, which is a longitudinal study of aging processes in men. Participants were 97 percent white with an average age of 53 years old. At the start of the study in 1975, none of the men had cancer or heart disease. Participants underwent physical exams and blood tests every three to five years until they died or dropped out of the study. Each participant completed a personality inventory that measured their neuroticism on a scale of 0 to 9 and a worry assessment tool that included 20 items. Neuroticism and worry are not the same thing, according to researchers. Neuroticism is a personality trait characterized by a tendency to interpret situations as threatening, stressful, or overwhelming, explained Dr. Lee. “Individuals with high levels of neuroticism are prone to experience negative emotions — such as fear, anxiety, sadness, and anger — more intensely and more frequently,” she said. “Worry refers to our attempts at problem-solving around an issue whose future outcome is uncertain and potentially positive or negative,” said Lee. Worry isn’t always bad. It can actually be helpful when it leads to constructive solutions, she added. “However, worry can also be unhealthy, especially when it becomes uncontrollable and interferes with our day-to-day functioning,” Lee said. During the 40-year follow-up period, investigators observed an increase in the levels of seven biological risk factors for cardiometabolic disease, which included systolic and diastolic blood pressure, total cholesterol, triglycerides, body-mass index, glucose, and erythrocyte sedimentation rate (an inflammatory marker). Men who had higher levels of anxiety at the beginning of the study had 10 to 13 percent greater likelihood of reaching high biological risk for cardiometabolic disease during that time, according to Lee. “They also had consistently higher biological risk for cardiometabolic disease than less-anxious men from midlife into old age. These findings support an association between anxiety and greater risk for developing heart disease and diabetes in men,” she said.
Men Who Worry More Likely to Have Unhealthy Habits
Researchers observed that men who reported worrying more were more likely to smoke, consume alcohol, and not exercise regularly. However, the association between worry and higher biological risk for cardiometabolic disease remained even after researchers controlled for those factors, as well as for socioeconomic factors, including income and education. It is unclear to what extent the results of this analysis are generalizable to the public, since the study participants were all male and nearly all white, noted Lee. The findings are also limited by the fact that all the participants were middle-aged when the study began, she added. “It would be important for future studies to evaluate if these associations exist among women, people from diverse racial and ethnic groups, and in more socioeconomically varying samples, and to consider how anxiety may relate to the development of cardiometabolic risk in much younger individuals than those in our study,” Lee said.
Findings Highlight the Important Role of Mental Health in Overall Health
“These findings reiterate the importance of screening for mental health difficulties, such as worries and anxiety, in men as early as their thirties and forties,” said Lee. While doctors may not screen or have conversations about reducing risk for heart disease and diabetes until older ages or the first signs of disease, these findings suggest that worries and anxiety are associated with processes that could lead to heart disease before any symptoms appear, she said. “Therefore, screening for mental health difficulties may be one way to prevent the development of cardiometabolic disease and promote heart health.” People should be aware that maintaining one’s mental well-being is potentially one of the ways in which we can preserve good cardiometabolic health, she added. “Oftentimes, people do not pay attention to heart health until after they receive a diagnosis,” said Lee. “Our findings suggest that it is important to pay attention to indicators of cardiometabolic health, such as one’s weight and blood pressure, at much younger ages, and doing so may have long-term benefits in preventing the development of heart disease and diabetes.”
