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 Table of Contents  
Year : 2022  |  Volume : 6  |  Issue : 1  |  Page : 22-25

Heart diseases, anxiety disorders, and negative thoughts

1 Mental Hospital, Lagankhel, Lalitpur, Nepal
2 National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal; Clinical Research Center, 1st Affiliated Hospital of Shantou University Medical College, Shantou-515041, Guangdong, China

Date of Submission29-Jul-2021
Date of Acceptance05-Oct-2021
Date of Web Publication10-Jan-2022

Correspondence Address:
Dr. Gehendra Mahara
Clinical Research Center, Shantou University Medical College, Shantou

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hm.hm_45_21

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The mind and the heart are inextricably linked. Depression, worry, loneliness, anger, and chronic stress are all negative mental states that can increase the risk of heart disease or worsen existing cardiac problems. Cardiomyopathy develops in response to suddenly hearing stressful news, such as a loved one diagnosed with cancer. Thus, intense emotions, such as anger, can also lead to abnormal heart rhythms. When you are stressed, your blood pressure and heart rate both rise. Chronic stress causes your body to produce harmful quantities of stress hormones such as cortisol, which can alter blood clots. All of these factors can lead to a heart attack or a stroke. Negative thoughts, feelings, or emotions may influence lifestyle patterns, increasing the risk of heart disease. People who are chronically stressed, nervous, sad, or angry are more likely to consume excessive amounts of alcohol, smoke, overeat, and exercise insufficiently– all harmful habits that are detrimental to their heart health.

Keywords: Anxiety, heart disease, negative thought

How to cite this article:
Karki M, Mahara G. Heart diseases, anxiety disorders, and negative thoughts. Heart Mind 2022;6:22-5

How to cite this URL:
Karki M, Mahara G. Heart diseases, anxiety disorders, and negative thoughts. Heart Mind [serial online] 2022 [cited 2023 Mar 27];6:22-5. Available from: http://www.heartmindjournal.org/text.asp?2022/6/1/22/335387

  Introduction Top

Heart disease is a leading cause of disability, paralysis, and even premature death worldwide.[1] Many behavioral risk factors of heart diseases are unhealthy diet, physical inactivity, tobacco use, and harmful alcohol use that affect or exacerbate blood pressure, raise blood glucose, lipid profile, and overweight and obesity.[2] These intermediate risk factors are the leading causess of heart conditions, such as blood vessel disease (coronary artery disease), heart rhythm problems (arrhythmias), congenital heart defects, heart valve disease, heart muscle disease, and different types of mental health problems (anxiety, negative thoughts, depression, and stress).[3] Likewise, several underlying determinants cause CVDs, e.g., Social, economic, and cultural changes, globalization, urbanization, and aging population, including poverty, stress, and hereditary factors.[3]

  Anxiety Disorders Top

Anxiety is the mind and body's reaction to stress. The stress response is the body's physiological response to stressful, dangerous, or unfamiliar situations, to which the mind/brain provides context. Anxiety may or may not result, although if the stress is chronic, anxiety is more likely to result and more likely to become problematic.[4] It's the sense of restlessness, distress, or dread feeling. The primary level of anxiety helps to stay alert and aware, but it feels abnormal for those suffering from an anxiety disorder. Due to anxiety, people live with too much fear and worry. They even worry about small things. If anxiety level increases and reaches extreme, then a panic attack may arise. Additionally, anxiety disorders increase physical medical illnesses, such as cardiovascular disorders, obesity, heart diseases. The common symptoms of anxiety disorders are panic, fear and uneasiness, feeling of panic, doom, or danger, sleep problems, not being able to stay calm and still, cold, sweaty, numb, or tingling hands or feet, shortness of breath, heart palpitations, dry mouth, nausea, tense muscles, dizziness, thinking about a problem over and over again and unable to stop (rumination), inability to concentrate, sweaty hands, limiting work activities, and life becomes stiff and cannot enjoy life.[5],[6],[7]

Moreover, according to the National Institute of Mental Health, there are five primary types of anxiety disorders.[4],[8],[9]

  • Generalized Anxiety Disorder (GAD): GAD is a form of anxiety characterized by persistent anxiety, increased worry, and tension, even when there is little or no cause for it
  • Obsessive-Compulsive Disorder (OCD) is an invisible illness marked by recurring, unwanted thoughts (obsessions), and repetitive activities (compulsions). Hand washing, counting, checking, and cleansing are all common repetitive behaviors that prevent or eliminate obsessive thinking. However, performing these so-called “rituals” only provides momentary respite, and failing to do so increases anxiety significantly
  • Panic Disorder: A panic condition is characterized by unpredictably and repeatedly intense moments of fear accompanied by physical symptoms such as chest discomfort, heart palpitations, shortness of breath, dizziness, or gastrointestinal distress
  • Post-Traumatic Stress Disorder (PTSD): PTSD is an anxiety disorder that can develop after exposure to a terrible incident or encounter in which substantial physical injury has happened or threatened. Violent personal assaults, natural or artificial disasters, accidents, or military combat are all examples of traumatic events that can lead to PTSD
  • Social Phobia (or Social Anxiety Disorder): Social phobia, also known as social anxiety disorder, is a type of anxiety disorder marked by extreme self-consciousness and overwhelming anxiety in everyday social situations. Social phobia can be limited to a single type of situation, such as a fear of speaking in an official or informal context, or of eating or drinking in front of others, or it can be so broad that a person has symptoms practically whenever they are with other people in its most extreme form.

Furthermore, there are some risk factors for anxiety disorder including history of mental health disorder, childhood sexual abuse, trauma, negative life events, sever illness or chronic health condition, substance abuse, being shy as a child, low self-esteem.[7] Although the exact cause and effect are unknown, studies conducted in various places have shown that the prevalence of heart disease is higher in people with relatively poor health, high levels of anxiety, and negative feelings/emotions or thoughts.[1],[10] Additionally, anxiety disorders can play a significant role in severely impacting heart disease. Thus, anxiety disorders such as panic disorder, post-traumatic stress disorder (PTSD), and Obsessive-Compulsive disorder contribute to heart disease and obstacles to recovery from the illness.[6] Because anxiety disorder increases the heart rate (tachycardia), increases blood pressure, and decreases heart rate variability.[6]

  Negative Thoughts, Feeling Top

People with negative feelings or emotions are also observed as socially isolated or biased. The effect of negative emotions and anxiety were also seen higher in women compared to men. It indicates that women with heart disease should pay special attention to avoid negative thinking and anxiety. Heart disease has established a close correlation with anxiety, depression, and negative emotions.[11]

It is typically because a negative idea has increased the stress hormones in the body that feel anxious, tense, terrified, furious, or stressed (adrenaline and cortisol). The heart rate, blood pressure, cholesterol, arterial wall inflammation, and blood clotting increased when adrenaline levels rise. The muscles stiffen up, and respiration becomes shallow and quick when stressed. It is not something to be afraid of; in fact, it is entirely normal and occurs to everyone. The only problem is that it does not feel nice. Suppose someone recently had a heart attack or have a lot of worrisome and stressful things going on in life. In that case, these negative sentiments and high adrenaline levels can linger for a long time, compromising your recovery and future health.[6],[12],[13]

Negativity and a lack of ability to cope with stress have an impact on behavior. People who are always concerned, angry, or tense and those who do not cope well with stress are more likely to turn to unhealthy behaviors for comfort, such as cigarettes, high-fat foods, alcohol, or inactivity. As a result for the sake of your heart and overall health, strive to prevent negative sensations from becoming overwhelming, and schedule time for things that help you relax on a regular basis.[12]

Negative attitudes or thoughts in life can exacerbate the disease, especially in people with heart disease.[6] Therefore, since the combination of negative emotions and heart disease is a deep relationship, patients with heart disease should pay special attention to those factors. Accordingly, negative emotions should be seen as a possible risk factor for heart disease later stage.[8] Consequently, always be aware of those symptoms of negative thoughts and try to avoid them as much as possible.

Healthy thinking can help control and prevent negative thoughts or feelings, including anxiety, depression, and stress, because that behavior can increase worry and fear. Therefore, cognitive-behavioral therapy is the best way to help replace negative emotions with accurate, encouraging ones to manage and reduce negative thoughts. Similarly, changing healthy thinking may take some time, but practicing healthy thinking is the best way to overcome it naturally.[6]

The good news is that everyone, regardless of their circumstances, can learn to think more positively. A person has complete control over the ideas. That implies you can learn to reframe your thinking so negative thoughts have less power over you, even if you are going through a difficult period or have already been through a stressful experience.[14]

We have the ability to manage our thoughts, even though it is not always straightforward. Learning how to do this and then putting it into practice in your life can go a long way toward assisting you in conquering anxiety and sadness by allowing you to stop ruminating.[15]

  Way and How to Reduce Anxiety and Negative Thoughts Top

If you are used to thinking negatively, you may make some small modifications to make your thoughts more optimistic. Here are some instances of how this works in practice:[12],[15],[16]

  • Rather than thinking, “I can't do anything correctly,” consider, “I've never done this before, but I'll give it my all and improve as I go.”
  • Replace negative thoughts with positive ones, such as “No one wants to talk to me.” “Rather than waiting for others to approach me, I can reach out to initiate interactions with them.”
  • If a buddy walks by and seems to ignore you, you could say to yourself, “I must have done something to anger her.” This can lead to you ruminating on what you have done and jumping to many assumptions. Instead, believe to yourself, “She must have been thinking about something and did not notice me as I walked by.”
  • Recognize and express your emotions. Talk to family and friends, keep reading books or journals, or join a support group. If you require assistance, get expert assistance.
  • Manage stress by practicing focused meditation, yoga, or deep breathing techniques on a daily basis.
  • Do not drink much and do not smoke.
  • Exercise. A 15-minute brisk walk, swimming, cycling, gardening, or dancing are all good options.
  • Consume a nutritious diet rich in omega-3 fatty acids, which have anti-inflammatory properties.

Furthermore, aside from anxiety disorder and negative thinking, we cannot ignore depressive disorder (DD), which is also a key factor and has a close relationship with CVD events.[17],[18] Depression is one of the leading causes of morbidity and poor quality of life in patients with cardiovascular disease.[19] Previous research has suggested a link between DDs and CVD.[20],[21],[22]

Depression is a psychiatric condition characterized by changes in mood, behavior, and affection regulators.[23],[24] According to the most recent World Health Organization data, CVD and DDs are the leading causes of disability in high-income countries.[25] Furthermore, there is mounting evidence that patients with CVD have more DD than the general population, and that people with DD are more likely to develop acute myocardial infarction (AMI), heart failure (HF), or stroke.[26],[27]

Individual's physical health can be influenced by a depressive state.[17] It has been discovered that depression is highly prevalent in CVD patients and predicts poor cardiovascular outcomes and increased health-care costs. It has also been found that one of every five patients with coronary artery disease or HF is depressed, which is at least three times higher than in the general population.[18],[19]

In addition, healthy thinking may not be enough to reduce negative thoughts. If you have worry and anxiety, and heart disease, you must talk to your doctor and therapist about any negative feelings or anxiety; otherwise, you may experience it, as it can damage your heart health. Some helpful tips include good food, being sociable, exercising regularly, and reducing stress as much as possible to save your overall health and lift your mood.

Ethical approval

This study is pourely based on previously published litratures, therefore, ethical statements is not applicable.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety disorders and cardiovascular disease. Curr Psychiatry Rep 2016;18:101.  Back to cited text no. 1
Mahara G, Liang J, Zhang Z, Ge Q, Zhang J. Associated Factors of Suboptimal Health Status Among Adolescents in China: A Cross-Sectional Study J Multidiscip Healthc 2021;14:1063-71, doi:10.2147/JMDH.S302826.  Back to cited text no. 2
World Health Organization Cardiovascular Diseases (CVDs) Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). [Last accessed on 2021 July 28].  Back to cited text no. 3
National Institute of Mental Health NIMH “ Anxiety Disorders. Available from: https://www.nimh.nih.gov/health/topics/anxiety-disorders. [Last accessed on 2021 Sep 22].  Back to cited text no. 4
Jovanovic T. Anxiety “ What Is Anxiety? Signs, Causes, Symptoms. Available from: https://www.anxiety.org/what-is-anxiety. [Last accessed on 2021 Jul 27].  Back to cited text no. 5
Michigan U. Anxiety: Stop Negative Thoughts | Michigan Medicine Available online: https://www.uofmhealth.org/health-library/uf9897. [Last accessed on 27 July 20]  Back to cited text no. 6
WebMD All About Anxiety Disorders: From Causes to Treatment and Prevention Available online: https://www.webmd.com/anxiety-panic/guide/anxiety-disorders (accessed on 27 October 2021).  Back to cited text no. 7
Heger E. What Causes Heart Disease? The Most Common Types and Risk Factors. Available from: https://www.insider.com/what-causes-heart-disease. [Last accessed on 2021 Jul 27].  Back to cited text no. 8
American Psychiatric Association What Are Anxiety Disorders? Available from: https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. [Last accessed on 2021 Sep 22].  Back to cited text no. 9
Bussotti M, Sommaruga M. Anxiety and depression in patients with pulmonary hypertension: Impact and management challenges. Vasc Health Risk Manag 2018;14:349-60.  Back to cited text no. 10
Tully PJ, Winefield HR, Baker RA, Denollet J, Pedersen SS, Wittert GA, et al. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: A five year longitudinal cohort study. Biopsychosoc Med 2015;9:14.  Back to cited text no. 11
Davis A. How Our Emotions Affect Our Heart Health | Edward-Elmhurst Health Available from: https://www.eehealth.org/blog/2019/03/emotions-heart-health/. [Last accessed on 2021 Jul 28].  Back to cited text no. 12
Human K. Negative Thoughts Can Cause Increased Heart Rate, Blood Pressure, Chol – Human Kinetics. Available from: https://us.humankinetics.com/blogs/excerpt/negative-thoughts-can-cause-increased-heart-rate-blood-pressure-cholesterol-artery-wall-inflammation-and-blood-clotting?_pos=1&_psq=negative%20thoughts&_ss=e&_v=1.0. [Last acessed on 2021 Jul 28].  Back to cited text no. 13
Emmons How Gratitude Can Help You Through Hard Times. Available from: https://greatergood.berkeley.edu/article/item/how_gratitude_can_help_you_through_hard_times. [Last accessed on 2021 Sep 20].  Back to cited text no. 14
White W. Rumination, Depression, and Anxiety: How Your Thoughts Impact Your Mental Health. Available from: https://www.mind-diagnostics.org/blog/depression/rumination-depression-and-anxiety-how-your-thoughts-impact-your-mental-health. [Last accessed on 2021 July 28].  Back to cited text no. 15
Batelaan NM, Seldenrijk A, Bot M, Balkom AJ, Penninx BW. Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. Br J Psychiatry 2016:208;223-31.  Back to cited text no. 16
Cohen BE, Edmondson D, Kronish IM. Editor's choice: State of the art review: Depression, stress, anxiety, and cardiovascular disease. Am J Hypert 2015;28:1295.  Back to cited text no. 17
Meng R, Yu C, Liu N, He M, Lv J, Guo Y, et al. Association between depression and all-cause and cardiovascular mortality in chinese adults. JAMA Netw Open 2020;3:e1921043.  Back to cited text no. 18
Amadio P, Zarà M, Sandrini L, Ieraci A, Barbieri SS. Depression and cardiovascular disease: The viewpoint of platelets. Int J Mol Sci 2020;21:7560.  Back to cited text no. 19
Harshfield EL, Pennells L, Schwartz JE, Willeit P, Kaptoge S, Bell S, et al. Association between depressive symptoms and incident cardiovascular diseases. JAMA 2020;324:2396-405.  Back to cited text no. 20
Carney R, Freedland K. Depression and coronary heart disease. Nature Rev Cardiol 2017;14:145-55.  Back to cited text no. 21
Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: A meta-analysis and systematic review. JAMA 2011;306:1241-9.  Back to cited text no. 22
Kidwell M, Ellenbroek BA. Heart and soul: Heart rate variability and major depression. Behav Pharmacol 2018;29:152-64.  Back to cited text no. 23
Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, Vos T. et al. Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literature. Psychol Med 2013;43:471-81.  Back to cited text no. 24
GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-Adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the global burden of disease study 2016. Lancet 2017;390:1260-344.  Back to cited text no. 25
Gu L, Xie J, Long J, Chen Q, Chen Q, Pan R, et al. Epidemiology of major depressive disorder in mainland china: A systematic review. PLoS One 2013;8:e65356.  Back to cited text no. 26
Charlson FJ, Baxter AJ, Cheng HG, Shidhaye R, Whiteford HA. The burden of mental, neurological, and substance use disorders in China and India: A systematic analysis of community representative epidemiological studies. Lancet 2016;388:376-89. [doi: 10.1016/S0140-6736 (16) 30590-6].  Back to cited text no. 27


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