Hypochondria: How worrying over health increases risk of heart disease

20170111080000, Rachel Seah
Patients often fault unpleasant experiences to healthcare providers
While it is normal for individuals to be concerned over their health, hypochondriacs are those who take the worrying too far.

Ironically, such excessive worriers of health are found to have an increased risk of heart disease.

According to Emeritus Consultant Dr Chee Kuan Tsee of the Singapore Psychiatric Association, hypochondriasis is a primary obsessive rumination of physical or mental symptoms with no known causes, and falls under the umbrella of obsessive-compulsive disorder (OCD).

The World Health Organisation estimates at least 50 million from the Asian population to be hypochondriacs, of which only few receive medical treatment.

No relief despite tests show they are in the pink of health

For sufferers of hypochondria, hiccups, sweating, regular bowel movements and even a slight runny nose can ring alarms as symptoms of a serious medical issue.

They may excessively discuss health matters, spend a lot of time reading up on symptoms for possible illnesses and make frequent, unnecessary visits to their doctor. Medical tests with negative results may not even pacify their anxiety.

As a result, they live with a persistent, overwhelming fear that they have a serious medical illness that is undiagnosed.

A study of over 7,000 Norwegians revealed that individuals with anxiety posed a 73% increased chance of developing heart disease over the span of ten years, and linked the risks of ischemic heart disease with hypochondria.

Participants were surveyed regarding their lifestyle, education and health, and each underwent a physical examination. Hypochondriac participants were identified using the Whiteley Index, and the participants’ healths were followed-up over 12 years using national hospital data.

While researchers predicted that individuals with health anxiety would have a lower risk of developing heart disease, hypothesising that they would proactively make lifestyle choices and seek medical attention if symptoms arise, the study results revealed otherwise.

Although participants with high levels of health anxiety did consume less alcohol than others, they also smoked more and were less physically active.

Anxiety, not lifestyle habits, leads to heart disease

According to lead researcher, Dr Line Iden Berge, it is not the associated lifestyle factors, but the excessive worrying of health which leads to the increased risk of heart disease.

"We show that participants who self-reported high levels of health anxiety had a 70% increased risk of ischemic heart disease, after adjustments for established risk factors," Berge said.

Cardiologist Dr Thomas Klingenheben, agreed the notion, explaining that anxiety triggers a hyperactivity of the nervous system, which may ultimately cause vascular damage.

"General anxiety has a physiological effect on the heart, just like other stressors do," he said. "People with anxiety have a much higher resting heart rate than others - perhaps around 80 [beats per minute], when the average person might have a heart rate of around 60."

Mind over matter?

"A range of studies have shown that depression is also associated with increased risk of ischemic heart disease,” said Berge.

But just how much does the patient’s state of mind influence their health?

"As a clinical psychiatrist, I would say there is a strong connection between depression and health anxiety," Berge added. "In our study we also demonstrated a correlation between the two conditions."

According to Klingenheben, the study has implications for how doctors need to deal with hypochondriacs.

"Of course these are the people doctors don't really want to see," he says. "I have patients like this myself, who come in two or three times a year because they believe there is something wrong with their heart. But I think doctors will have to take this illness more seriously and treat the health anxiety itself."

"This new evidence of negative consequences over time underlines the importance of proper diagnosis and treatment for health anxiety," Berge also said, adding that healthcare providers should promote patient education and encourage patients suffering from hypochondria to seek necessary treatment, such as cognitive behavioural therapy. MIMS

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Sources:
https://www.theguardian.com/lifeandstyle/2016/nov/14/can-worrying-about-health-make-you-ill-anxiety
http://www.dw.com/en/hypochondria-and-the-heart-why-paranoia-might-be-killing-you/a-36340403
http://www.china.org.cn/english/2002/Sep/42893.htm
http://www.medicalnewstoday.com/articles/9983.php
http://www.straitstimes.com/singapore/health/call-for-greater-support-as-more-in-singapore-suffer-anxiety-illness
https://www.singaporepsychiatry.org.sg/obsessive-compulsive-disorders-a-short-piece-and-new-insights-on-treatment/