Most cardiac patients with elevated anxiety symptom scores met formal diagnostic criteria for an anxiety disorder, according to a screening analysis from the Heart and Mind randomized clinical trial.

The study published in the BMJ Open included patients with arrhythmia, heart failure, or ischaemic heart disease who completed the Hospital Anxiety and Depression Scale (HADS). Patients with a HADS-anxiety (HADS-A) score of ≥8 were invited for further assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID), conducted by trained cardiac nurses.

Among 7816 patients screened with HADS, 1803 patients (23%) had a HADS-A score ≥8. Of these, 398 patients (22%) agreed to undergo SCID interviews. Anxiety disorders were confirmed in 336 participants, representing 84% of those interviewed.

The mean participant age was 61 years, and 40% were women. The mean HADS-A score among interviewed participants was 11.3 (standard deviation 2.7). Generalized anxiety disorder was the most frequently identified subtype, affecting 61% of patients diagnosed with anxiety disorders. Panic disorder accounted for 23% of cases, while specific phobia was identified in 8% of participants.

The findings showed that elevated HADS-A scores frequently corresponded with clinically identifiable anxiety disorders in patients with cardiovascular disease. Anxiety symptoms were observed across patients with arrhythmia, heart failure, and ischaemic heart disease.

The study findings support routine assessment of anxiety symptoms in cardiac populations. Generalized anxiety disorder and panic disorder were the most commonly identified anxiety subtypes among affected patients.