Postmenopausal women with a recent history of panic attacks had a higher likelihood of experiencing chest pain during 24-hour AECG monitoring (OR 2.01; 95% CI 1.40-2.88) compared to those without.
Cross-Sectional (n=3,063)
Yes
Effect estimate: OR 2.01 (95% CI 1.40-2.88)
Background: Chest pain is a common symptom of panic attacks, but little is known about the relationship in older women among panic attacks, chest pain, and daily life ischemia. Methods: The authors conducted a cross-sectional survey of 3063 community-dwelling, generally healthy postmenopausal women enrolled between 1997 and 2000 in the Myocardial Ischemia and Migraine Study in 10 clinical centers of the 40-center Women’s Health Initiative. Participants, ages 50 to 79 years, completed a questionnaire about occurrence of panic attacks in the previous 6 months and underwent 24-hour ambulatory electrocardiogram monitoring (AECG); 2705 women had valid AECG recordings and panic attack questionnaires. ST depression on AECG, heart rate variability (HRV), and chest pain episodes were compared among women with and without a 6-month history of panic attack. Results: There was no difference in overall prevalence of ischemic episodes during AECG between women with and without panic attacks. Women with a recent history of panic were more likely to experience chest pain during AECG after controlling for potential confounders (odds ratio OR = 2.01; 95% confidence interval CI = 1.40–2.88), including both nonischemic (OR = 1.83; 95% CI = 1.26–2.65) and ischemic chest pain (OR = 4.94; 95% CI = 1.41–17.30). Although mean HRV was lower in those with panic attacks (p = .017), this was not significant after controlling for confounders. Conclusions: Postmenopausal women with a recent history of panic attacks do not appear to have more daily life ischemia as measured by occurrence of ST depression during 24-hour monitoring, but do have more chest pain and possibly lower HRV, suggesting that even sporadic panic attacks may be related to cardiovascular risk. PD = panic disorder; MIMS = Myocardial Ischemia and Migraine Study; WHI = Women’s Health Initiative; ECG = electrocardiogram; AECG = ambulatory ECG; HRV = heart rate variability; MI = myocardial infarction; CAD = coronary artery disease; CES-D = Center for Epidemiological Studies Depression Scale; CABG = coronary artery bypass surgery; CHD = coronary heart disease.
Smoller et al. (Wed,) conducted a cross-sectional in Panic attacks and daily life ischemia (n=3,063). Recent history of panic attacks (previous 6 months) vs. No recent history of panic attacks was evaluated on Chest pain episodes during 24-hour ambulatory ECG (OR 2.01, 95% CI 1.40-2.88). Postmenopausal women with a recent history of panic attacks had a higher likelihood of experiencing chest pain during 24-hour AECG monitoring (OR 2.01; 95% CI 1.40-2.88) compared to those without.