New research indicates that women with phobias, such as a fear of open spaces or heights, may be at increased risk for fatal heart disease, especially sudden cardiac death. However, the link is not that strong and may be explained, in large part, by factors associated with phobias, such as high blood pressure.

Previous reports have linked phobic anxiety with heart problems in men, but until now, this association had not been investigated in women, according to the report in the Circulation: Journal of the American Heart Association.

The new findings are based on an analysis of data from 72,359 women who participated in the Nurses’ Health Study. All of the subjects were free from heart disease in 1988 and were followed for 12 years to assess heart outcomes.

During follow-up, 97 sudden cardiac deaths, 267 heart disease deaths, and 930 non-fatal heart attacks occurred, lead author Dr. Christine Albert, from Brigham and Women’s Hospital in Boston, and colleagues note.

As the score on a standard phobia test increased, the risk of sudden cardiac death and fatal heart disease, but not non-fatal heart attack, rose, the authors point out. Moreover, women with the highest scores were 59 percent and 31 percent more likely to experience sudden cardiac death and fatal heart disease, respectively, than those with the lowest scores.

On final analysis, which accounted for other risk factors such as high blood pressure, diabetes, and High cholesterol, a trend between high phobic anxiety and sudden cardiac death remained. The association with fatal heart disease, by contrast, essentially disappeared.

“One of the reasons we did this study is that anxiety disorders, and phobic disorders in particular, tend to be more common in women,” Albert said in a statement. If phobias really do cause heart problems, “greater recognition and perhaps treating these disorders in women may lower their risk of dying from heart disease, especially sudden cardiac death.”

SOURCE: Circulation, February 1, 2005.