Anxiety and Cardiac Disease Mechanisms

Physiological pathways linking anxiety and cardiac disease include autonomic nervous system dysregulation and HPA axis dysregulation. Autonomic and HPA-axis changes may increase cortisol and catecholamine levels and decrease heart rate variability. Cardiac disease itself can become a source of anxiety for patients. Anxiety can influence cardiac risk behaviours such as smoking, obesity, excessive alcohol use, unhealthy diet, physical inactivity, and low treatment adherence. Behavioural pathways related to anxiety may worsen cardiovascular risk and outcomes.