Patients with panic disorder have nearly double the risk for coronary heart disease, and those also diagnosed with depression are at almost three times the risk, according to new research.

The study in the current issue of Psychosomatic Medicine focuses on the medical histories of nearly 40,000 people from the time they were first diagnosed as suffering from panic disorder.

Lead author Andres Gomez-Caminero, Ph.D., says the large cohort study "highlights, for the first time, the potential for additive effects of different psychiatric conditions on cardiovascular health --.and it really sets the foundation for new research in the area of cardiovascular risk estimation among patients with mental illness."

The report focuses on medical histories from a database of 17 million patients jointly maintained by 30 managed care providers.

Panic disorder involves unexpected and repeated episodes of intense fear accompanied by physical symptoms including chest pain, heart palpitations, shortness of breath, dizziness or abdominal distress. Panic disorder patients are more likely to be female, overweight, smokers and have a history of depression.

About 2.4 million Americans annually experience panic episodes, and the manifestations often mimic symptoms of a heart attack. The disorder can be treated by medications and psychotherapy.

Coronary heart disease is an umbrella term for processes that reduce the arterial flow of blood to the heart. Nearly 14 million Americans have a history of coronary heart disease, which is the leading cause of death in the United States.

The authors of the study say the mechanism by which incidents of panic disorder might trigger coronary heart disease is not known. However, they note that certain stress responses to depression already have been shown to increase the risk of coronary heart disease, which reinforces the study's conclusion that the association between a panic disorder and coronary heart disease "suggests the need for cardiologists and internists to monitor panic disorder" in the interest of cutting the risk of coronary heart disease.

Jack Gorman, M.D., a professor pf psychiatry and neuroscience at the Mount Sinai School of Medicine, calls the study, "one more piece of evidence that mood and anxiety disorders significantly increase the risk for heart disease," adding that more work is needed "to understand the basic biological link between the brain and the heart that explains these phenomena."