Assessment of Anxiety Severity and its Association with Cardiac Autonomic Function Tests and Cardiovascular Risk Factors in Patients with Anxiety Disorder

Author(s): Kavitha Natarajan, Pravati Pal, Gopal Krushna Pal, Balaji Bharadwaj, Nivedita Nanda.

Background: Anxiety disorders are persistent, excessive, and difficultto- control anxiety and worry, with a global prevalence of 0.9% to 28.3%. Psychosocial factors, like anxiety, have a significant impact on cardiovascular health, comparable to traditional CV risk factors, and often remain under-recognized. Aim: This study explores the relationship between anxiety severity and cardiovascular risk factors in anxiety disorder patients. Methods: This study involved 140 anxiety disorder patients. Anxiety severity was assessed using the hamilton anxiety rating scale. Cardiovascular autonomic functions, like heart rate variability, heart rate response to standing, heart rate response to deep breathing, blood pressure response to isometric handgrip, and baroreflex sensitivity, were measured. Also, Quality of life, metabolic profile and inflammatory markers were assessed across various anxiety severity levels. Results: Among participants, 21% had mild, 21% had mild to moderate, 29% had moderate to severe, and 29% had very severe anxiety. The heart rate variability indices showed increased sympathetic and decreased parasympathetic activity as the anxiety severity increased. Also, parasympathetic reactivity and baroreflex sensitivity diminished, while sympathetic reactivity increased with greater anxiety. Quality of life scores decreased as anxiety intensified. Biochemically, anxiety severity was associated with increased levels of metabolic, stress and inflammatory markers. Conclusion: The findings reveal that 60% of anxiety disorder patients have moderate to very severe anxiety, linking anxiety severity to disruptions in cardiovascular function. This underscores the need for treatment strategies addressing both mental and cardiovascular health