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Older women who experience at least(1) one full-blown(2) panic attack(3) may have an increased risk of(4) having a heart attack(5) or stroke(6) and an increased risk of death in the next five years, according to(7) a report in the October issue(8) of Archives(9) of General Psychiatry(10), one of the JAMA(11)/Archives journals(12).

Panic attacks involve(13) the sudden development of fear, anxiety(14) or extreme(15) discomfort(16) accompanied by(17) four or more additional symptoms(18), according to background information(19) in the article. They may occur(20) sporadically(21) or as part of an anxiety disorder(22), such as panic disorder(23), social anxiety disorder(24) or phobias(25).

Jordan W. Smoller, M.D., Sc.D., of Massachusetts General Hospital(26), Boston, and colleagues(27) studied 3,369 healthy postmenopausal(28) women (age 51 to 83, average(29) age 65.9). When they entered the study between 1997 and 2000, the women filled out(30) a questionnaire(31) about the occurrence(32) of panic attacks in the previous(33) six months. They were then followed for an average of 5.3 years to see whether they had a heart attack or stroke or died from any cause.

About 10 percent of the women reported having a full-blown panic attack in the six months prior to(34) the study. After the researchers(35) adjusted for(36) other cardiovascular(37) risk factors(38), having one or more panic attacks was associated with(39) four times the risk of myocardial infarction(40) (heart attack), three times the risk of having a heart attack or stroke and nearly twice the risk of death from any cause. These associations(41) remained after controlling for(42) depression(43), suggesting that panic attacks may be a separate, independent(44) risk factor for cardiovascular events(45).