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Generalised anxiety disorder doubles risk of cardiovascular events in people with stable coronary heart disease

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Does generalised anxiety disorder (GAD) affect cardiovascular events associated with coronary heart disease (CHD)?


1015 patients with stable coronary heart. Eligible patients had at least one of the following: history of myocardial infarction (MI), 50% stenosis in one or more coronary vessels (angiographic evidence), history of coronary revascularization, diagnosis of CHD or previous evidence of exercise-induced ischaemia (treadmill or nuclear testing).


Medical centres and public health clinics in San Francisco, USA; September 2000 to December 2002.

Prognostic factors

GAD according to Diagnostic Interview Schedule for DSM-IV criteria.


Cardiovascular events occurring between baseline and March 2009. Events included stroke, heart failure, MI, transient ischaemic attack or death. Heart failure was defined as hospitalisation for a clinical syndrome involving at least two of the following: orthopnoea, third heart sound, pulmonary rales, paroxysmal nocturnal dyspnoea, elevated jugular venous pressure, cardiomegaly or pulmonary oedema on chest radiography. Non-fatal MI was defined based on the presence of symptoms, electrocardiographic changes and cardiac enzymes using standard criteria.



Prospective cohort study. …

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  • Sources of funding The VA Epidemiology (Merit Review) Program; the VA Health Services Research and Development service Career Development Program, The National Heart, Lung, and Blood Institute, The American Federation for Aging Research, The Robert Wood Johnson Foundation, The Ischemia Research and Education Foundation and the Nancy Kirwan Heart Fund


  • Competing interests None.

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