People who have heart disease have an increased risk of dying if they also suffer from anxiety, a new study indicates.

This risk jumps even more if they suffer from both anxiety and depression.

According to US scientists, while a number of studies have found a link between an increased risk of death in heart disease patients and depression, ‘anxiety hasn't received as much attention'.

They decided to investigate this further. They followed the progress of over 900 patients with heart disease. All had their levels of anxiety and depression assessed both before and after a heart-related medical procedure.

After taking into account factors that could have affected the risk of death, such as age and heart failure, the scientists found that those with heart disease had twice the risk of dying from any cause if they had anxiety compared to those without anxiety.

The risk of death was tripled if they had both anxiety and depression.

The scientists explained that anxiety increases the activity of the part of the nervous system which is responsible for producing adrenaline. This in turn controls blood pressure.

As a result, people who are very anxious ‘are more likely to have difficulty sleeping and to develop high blood pressure', they said.

Depression's link to death is more related to behavioural factors.

"Depression results in lack of adherence to medical advice and treatments, along with behaviours like smoking and being sedentary," the scientists from Duke University Medical Center in North Carolina explained.

They insisted that anxiety should now be considered ‘as important as depression' when it comes to heart disease patients.

"Anxiety-reducing medications combined with stress management could improve the outcome for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention involving more frequent outpatient monitoring and incentives to improve adherence," they added.

Details of these findings are published in the Journal of the American Heart Association.

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