Cardiovascular Diseases Clinical Trial
To evaluate the hypothesis that chronic anxiety and/or anxiety disorders resulted in hyperkinetic cardiovascular autonomic regulation, often associated with increased coronary risk.
BACKGROUND:
Prospective epidemiologic data indicate a strong relationship of chronic anxiety and/or
anxiety disorders to risk of sudden cardiac death. Other studies have shown that cardiac
autonomic mechanisms are altered among stably anxious individuals in the direction of
reduced parasympathetic and elevated sympathetic control. The latter investigations,
however, have been based on very small clinic samples and have been incomplete in their
assessment of cardiovascular regulation in anxiety.
This investigation was the first large-scale population-based research examining the
cardiovascular physiology of anxiety, and helped to increase understanding of the reported
association between anxiety and sudden cardiac death. This study also helped to identify
groups in the general population at increased risk of sudden death.
DESIGN NARRATIVE:
The study used an ongoing well-characterized cohort, the VA Normative Aging Study (NAS), to
recruit middle-aged and older community-dwelling men and women into the study. Using a
variety of validated psychological and psychiatric screening instruments--including the
Brief Symptom Inventory, the Composite International Diagnostic Interview, the Spielberger
State-Trait Anxiety Inventory, and the Crown-Crisp Index--the study population was
characterized in terms of symptoms of anxiety and diagnosis of anxiety disorders.
Cardiovascular autonomic control was then assessed among anxious and non-anxious individuals
using non-invasive time-domain and power-spectral measures of heart rate and blood pressure
variability. Cardiac output, total peripheral resistance, and end-tidal pCO2 were
simultaneously assessed.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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