A new study linking panic attacks with heart attacks and stroke in older women suggests that it may be important for women who have had a panic attack to carefully monitor and reduce cardiovascular risk, according to the study. The study of over 3,000 older women found that women who had at least one full-blown panic attack in a 6-month period were three times more likely to suffer a heart attack or stroke within the next five years compared to women who didn't have a panic attack. Smoking, depression, inactivity and high blood pressure were taken into account in the study, and the researchers still found panic attacks as a risk for heart attack and stroke. Panic attacks are characterized by many symptoms, including rapid pulse, difficulty breathing, chest pain and a fear of dying, according to Richard Kunze, a retired cardiologist of 30 years. Epinephrine and cortisone, the stress hormones that are released during a panic attack, increase the heart rate and may cause unnecessary stress to the heart, Kunze said. This could possibly lead to heart damage and an irregular heart rhythm, especially for women who have frequent panic attacks. Lasting damage to the heart could occur if the heart rate during a panic attack exceeds 150 beats per minute. "It would be like them doing exercise that their heart is not used to," he said. The study relied on the women's memory of having a panic attack, rather than an actual diagnosis from a doctor, which was cited as a flaw in the study. Helda Montero, student counseling specialist at University of Florida's Student Health Care Center, said that a panic attack is so acute that it would be hard for someone not to know that he or she had had one. Typically, panic attacks are more common in women than men. The treatment for reoccurring panic attacks usually consists of cognitive-behavioral therapy, medication and working through the initial problem that triggered the panic attacks, Yoga and meditation have also been found to help control anxiety and panic attacks, Montero said. With this new study, preventative therapy for heart attack and stroke may need to be included in this treatment. Older women with panic attacks may consider going on an anti-anxiety medication to help control the panic attacks and lower the heart rate and blood pressure. If a woman with panic attacks experiences exercise intolerance or shortness of breath, an annual electrocardiogram is advised, as well as monitoring cholesterol and blood pressure, according to Kunze. Medical professionals are just finding out that a woman's heart and the way a woman experiences a heart attack is very different from a man. A woman may not get the classic stabbing in the chest that a man usually has during a heart attack. Instead, a woman may have more pain in her jaw and down her left arm, Kunze said. For many women, a doctor may not even know that a woman had had a heart attack until an EKG suggests it, he said. "At one time they thought women were just small men, but now they are finding out they are very different than men when it comes to the heart," Kunze said. For women especially, more emphasis needs to be placed on the mental and emotional aspect when making a diagnosis and prescribing treatment, according to Montero. She said that physical health is interconnected with mental and emotional health. By just treating the physical ailment, "you are just putting a band-aid on it." Many mental health issues have been linked in past research to cardiovascular problems, including depression, hostility, fear and anxiety, according to the study. The study was funded by GlaxoSmithKline, the company who makes the anti-anxiety drug Paxil. Kunze said he questioned whether the pharmaceutical company's motives for conducting the study could have been for financial gain, and if their involvement could have skewed the results. The study consisted of 3,243 women. Forty-one of these women had a heart attack, and 40 of them had a stroke. With such a small sample, more research and studies need to be done in order to know the significance this study may have. Kunze suggested taking the women who had a heart attack or stoke in the study, and randomly placing the women on beta-blockers, anti-anxiety medication or placebos to determine how many women had repeated cardiovascular problems over the next 10 years. "We have a long way to go before we will figure this all out," Kunze said. | 
