Symptoms of anxiety and depression and risk of atrial fibrillation—The HUNT study

Abstract

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Anxiety and depression may activate the autonomic nervous system which is likely to play an important role in the etiology of AF. However, little is known about the association between symptoms of anxiety and depression and risk of AF.Objective: This study aimed to assess the association between symptoms of anxiety and depression and risk of AF. Methods: In a population-based study, 37,402 adult residents were followed for incident AF from 2006 to 2008 until 2015. Participants were classified according to data on anxiety and depression symptoms. Cox proportional regression models were used to adjust for common AF risk factors. Results: During a median follow-up of 8.1 years, 1433 (3.8%) participants developed AF. In comparisons with no anxiety symptoms, the multivariable-adjusted hazard ratios (HRs) were 1.1 (95% CI: 0.9-1.5) for mild to moderate anxiety symptoms and 1.0 (95% CI: 0.8-1.4) for severe anxiety symptoms. In comparisons with no depression symptoms, the multivariable-adjusted HRs were 1.5 (95% CI: 1.2-1.8) for mild to moderate depression symptoms and 0.9 (95% CI: 0.6-1.3) for severe depression symptoms. Recurrent anxiety/depression symptoms were not associated with increased AF risk. Conclusions: In this large, population-based study, we found no evidence of an association between symptoms of anxiety or severe depression and AF risk, even for recurrent anxiety or depression symptoms. An unexpected association of symptoms of mild to moderate depression with increased AF risk requires confirmation in other studies. Our findings add to the sparse literature on symptoms of anxiety and depression and risk of AF.

Association between anxiety symptoms and atrial fibrillation in a community cohort of Chinese older adults: a case-control study

“…However, some population-based studies have reported contrary results. Among 37,402 adult residents in Norway, anxiety, assessed using the Hospital Anxiety and Depression Scale, was not associated with incident AF after adjusting for risk factors (symptoms of mild to moderate anxiety, HR 1.1, 95% CI 0.9–1.5; symptoms of severe anxiety, HR 1.0, 95% CI 0.8–1.4 ) [ 17 ]. Among 30,746 female individuals in the United States, the results of an age-stratified proportional hazards model showed that anxiety, assessed with a 5-item subscale of the Short-Form 36 health status survey, was unrelated to AF risk (HR 0.90, 95% CI 0.47–1.75) [ 16 ].…”

“…Anxiety was associated with AF in hospitalized patients [ 12 , 13 ], and a prospective study showed that panic disorder (a common type of anxiety disorder) was a risk factor for AF in a Chinese population [ 14 ]. However, 3 prospective studies failed to find evidence that anxiety was a risk factor for AF in a Caucasian population in the United States or Norway [ 11 , 15 – 17 ].…”

Fibrilação Atrial (Parte 1): Fisiopatologia, Fatores de Risco e Bases Terapêuticas

“…Em um recente estudo populacional com 37.402 adultos, não houve relação entre os sintomas de ansiedade ou depressão severa e FA. 65 A Figura 3 resume os principais fatores de risco modificáveis relacionados à qualidade de vida.…”

Association of Depression With Atrial Fibrillation in South Korean Adults

“…In the Trøndelag Health (HUNT) study, the authors found no association between symptoms of anxiety or severe depression and the risk of new-onset AF. 15 In contrast, researchers from Denmark reported an increased risk of new-onset AF in antidepressant users, especially before initiation of treatment for depression. 16 Depression is a disease that can be controlled; therefore, evaluation of the association between depression and AF is important from a public health care perspective.…”