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Panic attacks, daily life ischemia, and chest pain in postmenopausal women
Journal article   Peer reviewed

Panic attacks, daily life ischemia, and chest pain in postmenopausal women

Jordan W Smoller, Mark H Pollack, Sylvia Wassertheil-Smoller, Robert Brunner, David Curb, James Torner, Albert Oberman, Susan L Hendrix, Judith Hsia and David S Sheps
Psychosomatic medicine, Vol.68(6), pp.824-832
11/2006
DOI: 10.1097/01.psy.0000244383.19453.c5
PMID: 17101813

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Abstract

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. 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. 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. 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.
 Heart Rate Cross-Sectional Studies Humans Middle Aged Risk Factors Activities of Daily Living Panic Disorder Chest Pain - etiology Health Surveys Myocardial Ischemia - psychology Chest Pain - psychology Electrocardiography Postmenopause Female Aged

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