Original Article

Relationship between Anxiety Disorders and Anthropometric Indices, Risk Factors, and Symptoms of Cardiovascular Disorder in Children and Adolescents

Abstract

Objective: Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years.

Method: In this community-based study, multistage cluster sampling method was used. We randomly selected 1174 children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10- 14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants.

Results: A total of 1035 children and adolescents participated in this study. The results showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, and hypertension. According to the results, FBS and LDL are a predictor for anxiety disorders.

Conclusion: There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard.

1. Marks I, Lader M. Anxiety states (anxiety neurosis): a review. J Nerv Ment Dis. 1973;156(1):3-18.
2. Agheli N, Hajaran M. Anxiety, Cardiovascular symptoms and serum Lipids level. IJPCP. 2004;9(4):56-62.
3. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry: Lippincott Williams & Wilkins; 2011.
4. Eftekhar Ardebili H, Barkati H, Omrani A, Khosravizadeh O, Mohseni M. Relationship between life style-related factors with cardiac ischemia among inpatients: A case-control study. JHMI. 2015;2(1):1-4.
5. Martens EJ, Nyklícek I, Szabó BM, Kupper N. Depression and anxiety as predictors of heart rate variability after myocardial infarction. Psychol Med. 2008;38(3):375-83.
6. Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJ, Penninx BJ. Depression, anxiety and 6-year risk of cardiovascular disease. J Psychosom Res. 2015;78(2):123-9.
7. Smith PJ, Blumenthal JA. [Psychiatric and behavioral aspects of cardiovascular disease: epidemiology, mechanisms, and treatment]. Rev Esp Cardiol. 2011;64(10):924-33.
8. Allgulander C. Morbid anxiety as a risk factor in patients with somatic diseases: a review of recent findings. Eur J Neurol. 2010;2(1):31.
9. Mykletun A, Bjerkeset O, Dewey M, Prince M, Overland S, Stewart R. Anxiety, depression, and cause-specific mortality: the HUNT study. Psychosom Med. 2007;69(4):323-31.
10. Yasuda N, Mino Y, Koda S, Ohara H. The differential influence of distinct clusters of psychiatric symptoms, as assessed by the general health questionnaire, on cause of death in older persons living in a rural community of Japan. J Am Geriatr Soc. 2002;50(2):313-20.
11. Blumenthal JA, Smith PJ. Risk factors: Anxiety and risk of cardiac events. Nat Rev Cardiol. 2010;7(11):606-8.
12. Roest AM, Martens EJ, de Jonge P, Denollet J. Anxiety and risk of incident coronary heart disease: a meta-analysis. J Am Coll Cardiol. 2010;56(1):38-46.
13. Ouakinin SR. Anxiety as a Risk Factor for Cardiovascular Diseases. Front Psychiatry. 2016;7:25.
14. Sadeghian E, Moghadari Kosha M, Gorji S. The study of mental health status in high school female students in hamadan city. UMSHA. 2010;17(3):39-45.
15. Lykouras L, Michopoulos J. Anxiety disorders and obesity. Psychiatriki. 2011;22(4):307-13.
16. Halmi KA. Anorexia nervosa: an increasing problem in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):100-3.
17. Zhang Z, Su H, Peng Q, Yang Q, Cheng X. Exam anxiety induces significant blood pressure and heart rate increase in college students. Clin Exp Hypertens. 2011;33(5):281-6.
18. Esposito M, Gallai B, Roccella M, Marotta R, Lavano F, Lavano SM, et al. Anxiety and depression levels in prepubertal obese children: a case-control study. Neuropsychiatr Dis Treat. 2014;10:1897-902.
19. Yannakoulia M, Panagiotakos DB, Pitsavos C, Tsetsekou E, Fappa E, Papageorgiou C, et al. Eating habits in relations to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA Study. Appetite. 2008;51(3):519-25.
20. Javadi M, Jourabchi Z, Shafikhani AA, Tajik E. Prevalence of depression and anxiety and their association with body mass index among high school students in Qazvin, Iran, 2013-2014. Electron Physician. 2017;9(6):4655-60.
21. Goldfield GS, Legg C. Dietary restraint, anxiety, and the relative reinforcing value of snack food in non-obese women. Eat Behav. 2006;7(4):323-32.
22. Shomaker LB, Tanofsky-Kraff M, Young-Hyman D, Han JC, Yanoff LB, Brady SM, et al. Psychological symptoms and insulin sensitivity in adolescents. Pediatr Diabetes. 2010;11(6):417-23.
23. Apter A, Laufer N, Bar-Sever M, Har-Even D, Ofek H, Weizman A. Serum cholesterol, suicidal tendencies, impulsivity, aggression, and depression in adolescent psychiatric inpatients. Biol Psychiatry. 1999;46(4):532-41.
24. Goldbacher EM, Matthews KA. Are psychological characteristics related to risk of the metabolic syndrome? A review of the literature. Ann Behav Med. 2007;34(3):240-52.
25. Hanć T, Janicka K, Durda M, Cieślik J. An association between adverse events, anxiety and body size of adolescents. J Biosoc Sci. 2014;46(1):122-38.
26. Noorbala AA, Bagheri Yazdi SA, Faghihzadeh S, Kamali K, Faghihzadeh E, Hajebi A, et al. A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Yazd, Iran. Arch Iran Med. 2017;20(11 Suppl. 1):S123-s6.
27. Mohammadi MR, Ahmadi N, Salmanian M, Asadian-Koohestani F, Ghanizadeh A, Alavi A, et al. Psychiatric Disorders in Iranian Children and Adolescents. Iran J Psychiatry. 2016;11(2):87-98.
28. Akbari Z, Mirzaei M, Azizi R. The Quantity and Quality of Sleep and their Relationship to Obesity. JMUMS. 2016;26(137):128-36.
29. Talepasand S, Mohammadi MR, Alavi SS, Khaleghi A, Sajedi Z, Akbari P, et al. Psychiatric disorders in children and adolescents: Prevalence and sociodemographic correlates in Semnan Province in Iran. Asian J Psychiatr. 2019;40:9-14.
30. Mohammadi MR, Khaleghi A, Mostafavi SA, Ahmadi N, Kamali K, Hooshyari Z, et al. Gender Determines the Pattern of Correlation between Body Mass Index and Major Depressive Disorder among Children and Adolescents: Results from Iranian Children and Adolescents' Psychiatric Disorders Study. Child Obes. 2019;15(5):331-7.
31. Chalmers JA, Quintana DS, Abbott MJ, Kemp AH. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis. Front Psychiatry. 2014;5:80.
32. Vogelzangs N, Seldenrijk A, Beekman AT, van Hout HP, de Jonge P, Penninx BW. Cardiovascular disease in persons with depressive and anxiety disorders. J Affect Disord. 2010;125(1-3):241-8.
33. Romieu I, Dossus L, Barquera S, Blottière HM, Franks PW, Gunter M, et al. Energy balance and obesity: what are the main drivers? Cancer Causes Control. 2017;28(3):247-58.
34. Stein DJ, Aguilar-Gaxiola S, Alonso J, Bruffaerts R, de Jonge P, Liu Z, et al. Associations between mental disorders and subsequent onset of hypertension. Gen Hosp Psychiatry. 2014;36(2):142-9.
35. Ma LL, Kong DG, Qi XW, Wang LX. Generalized anxiety disorder and the circadian rhythm of blood pressure in patients with hypertension. Int J Psychiatry Clin Pract. 2008;12(4):292-5.
36. Dennis PA, Watkins LL, Calhoun PS, Oddone A, Sherwood A, Dennis MF, et al. Posttraumatic stress, heart rate variability, and the mediating role of behavioral health risks. Psychosom Med. 2014;76(8):629-37.
37. O'Donovan A, Slavich GM, Epel ES, Neylan TC. Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging. Neurosci Biobehav Rev. 2013;37(1):96-108.
38. Carter JR, Goldstein DS. Sympathoneural and adrenomedullary responses to mental stress. Compr Physiol. 2015;5(1):119-46.
39. Garfinkel SN, Eccles JA, Critchley HD. The Heart, the brain, and the regulation of emotion. JAMA psychiatry. 2015;72(11):1071-2.
40. Player MS, Peterson LE. Anxiety disorders, hypertension, and cardiovascular risk: a review. Int J Psychiatry Med. 2011;41(4):365-77.
Files
IssueVol 16 No 4 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v16i4.7228
Keywords
Adolescent Anxiety Disorders Cardiovascular Disorder Child Risk Factors
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ahmadi N, Farahzadi MH, Mohammadi MR, Mostafavi S-A, Moeeini SS, Shahvazian N, Saghafi F, Negintaji S, Bidaki R. Relationship between Anxiety Disorders and Anthropometric Indices, Risk Factors, and Symptoms of Cardiovascular Disorder in Children and Adolescents. Iran J Psychiatry. 2021;16(4):409-417.