Panic attacks pose risk

CHICAGO — The rapid pulse and shortness of breath of a panic attack can feel like a heart attack, and it may signal heart trouble down the road, a study of more than 3,000 older women suggests.

Women who reported at least one full-blown panic attack during a six-month period were three times more likely to have a heart attack or stroke over the next five years than women who didn't report a panic attack.

The researchers took into account other risk factors such as smoking, high blood pressure, inactivity and depression and still found that panic attacks raised risk.

The findings add panic attacks to a list of mental-health issues — depression, fear, hostility and anxiety — already linked in previous research to heart problems, said study co-author Dr. Jordan Smoller of Boston's Massachusetts General Hospital.

"Postmenopausal women who are experiencing panic attacks may be a subgroup with elevated risk," Smoller said. "Monitoring them and reducing their cardiovascular risk may be important."

The study, published in Monday's Archives of General Psychiatry, wasn't designed to explain the link, Smoller said. He speculated that a panic attack may trigger heart rhythm problems or that stress hormones released during an attack may harm the heart.

The findings don't surprise Susie Rissler, 51, of Terre Haute, Ind. A panic attack sufferer since childhood, she's also has had three mini-strokes.

"You feel like the whole world is caving in," Rissler said of her panic attacks, which can include a racing heartbeat and chest pains. "I've had shaking, sweating, curling up in a ball totally afraid to even look around. Panic attacks can really destroy a person in a lot of different ways."

Some of the reported panic symptoms may have been heart problems in disguise, Smoller said. Symptoms such as racing heart, chest pain or shortness of breath, experienced as a panic attack, may have been caused by an undiagnosed heart problem.

"One study doesn't settle a question," he cautioned. "The number of events seen in this sample is still relatively small." Forty-one of the 3,243 women in the analysis had a heart attack or death from a heart problem. An additional 40 had strokes.

The study, which enrolled women from 1997-2000 and followed them for five years, was funded by the drug company Glaxo Wellcome, which is now GlaxoSmithKline PLC. The company makes Paxil, an anti-anxiety drug. Some of the study's co-authors reported financial ties to that company and others.