Younger Men Pre-disposed to Developing Heart Disease and Diabetes Through Worrying
Anxious middle-aged men may be at greater risk of suffering from heart disease, stroke and/or type 2 diabetes (cardiometabolic) as they age, according to new research recently published in the Journal of the American Heart Association.
The study uncovered:
- Between ages 33 to 65, the average number of cardiometabolic high-risk factors increased by about one per decade, averaging 3.8 risk factors by age 65, followed by a slower increase per decade after age 65.
- At all ages, participants with higher levels of neuroticism had a greater number of high-risk cardiometabolic factors.
- Higher neuroticism was associated with a 13% higher likelihood of having six or more cardiometabolic disease risk factors, after adjusting for demographic characteristics (such as income and education) and family history of heart disease.
- Higher worry levels were associated with a 10% higher likelihood of having six or more cardiometabolic disease risk factors after adjusting for demographic characteristics.
The investigators analysed data on participants in the Normative Aging Study, which is a longitudinal study of ageing processes in men, tracking the relationship between anxiety and cardiometabolic disease risk factors over time.
The study includes both veterans and non-veterans. This analysis included 1,561 men (97% white), who were an average age of 53 years in 1975. The men completed baseline assessments of neuroticism and worry and did not have cardiovascular disease or cancer at that time. A worry assessment tool established how often they worried throughout the day which was supported by a personality inventory that assessed neuroticism on a scale of 0–9.
After their baseline assessment, the men had physical exams and blood tests every 3-5 years until they either died or dropped out of the study.
The research team used follow-up data through 2015. During follow-up visits, seven cardiometabolic risk factors were measured: systolic (top number) blood pressure; diastolic (bottom number) blood pressure; total cholesterol; triglycerides; obesity (assessed by body mass index); fasting blood sugar levels; and the erythrocyte sedimentation rate (ESR), a marker of inflammation.
“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, Ph.D., 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 Posttraumatic Stress Disorder at the U.S. Department of Veterans Affairs, both in Boston.
“Neuroticism is a personality trait characterized by a tendency to interpret situations as threatening, stressful and/or overwhelming. Individuals with high levels of neuroticism are prone to experience negative emotions – such as fear, anxiety, sadness and anger – more intensely and more frequently,” explained Lee. “Worry refers to our attempts at problem-solving around an issue whose future outcome is uncertain and potentially positive or negative. Worry can be adaptive, for example, when it leads us to constructive solutions. However, worry can also be unhealthy, especially when it becomes uncontrollable and interferes with our day-to-day functioning.”
A risk factor for the cardiometabolic disease was considered in the high-risk range if the test results for the risk factor was higher than the cut-point established by national guidelines, or if the participant was taking any medicines to manage that risk factor (such as cholesterol-lowering medications). Each participant was assigned a risk factor count score, one point for each of the seven risk factors classified as high-risk. The men were then stratified based on whether they did or did not develop six or more high-risk factors during the follow-up period.
“Having six or more high-risk cardiometabolic markers suggests that an individual is very likely to develop or has already developed the cardiometabolic disease,” said Lee, “We found that cardiometabolic disease risk increased as men aged, from their 30s into their 80s, irrespective of anxiety levels, while men who had higher levels of anxiety and worry consistently had a higher likelihood of developing the cardiometabolic disease over time than those with lower levels of anxiety or worry.”
Lee went on to explain, “While we do not know whether treatment of anxiety and worry may lower one’s cardiometabolic risk, anxious and worry-prone individuals should pay greater attention to their cardiometabolic health. For example, by having routine health check-ups and being proactive in managing their cardiometabolic disease risk levels (such as taking medications for high blood pressure and maintaining a healthy weight), they may be able to decrease their likelihood of developing the cardiometabolic disease.”
Lee finished with, “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.”
It is unclear to what extent the results of this analysis are generalisable to the public since the study participants were all male and nearly all white. In addition, although participants were followed for four decades, they were middle-aged when the study began.
Co-authors are Kevin J. Grimm, Ph.D.; Avron Spiro III, Ph.D.; and Laura D. Kubzansky, M.P.H., Ph.D. Authors’ disclosures are listed in the manuscript.
The study was supported by the National Institute on Aging and the National Center for Advancing Translational Sciences, which are divisions of the National Institutes of Health.
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Article title:
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Neuroticism, Worry, and Cardiometabolic Risk Trajectories: Findings From a 40-Year Study of Men
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Website title:
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Journal of the American Heart Association
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URL:
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https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022006
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Additional Resources:
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