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Objective: Phobic anxiety has been associated with increased risk of cardiovascular disease, but
the underlying mechanisms are poorly understood. We aimed to determine whether associations
of phobic anxiety with several known markers of cardiovascular disease might be contributors.
Research design and methods: We used a 16-point validated index (Crown-Crisp) measured in
1988 to categorize 984 women with type 2 diabetes from the Nurses’ Health Study as having
low, moderate, or high phobic anxiety. Groups were then compared for differences in
adipokines (adiponectin and leptin), inflammatory markers (C-reactive protein and TNF- α
receptor II) and markers of endothelial function (sE-selectin, sICAM-1) measured on blood
samples provided between 1989 and 1990.
Results: Higher levels of phobic anxiety were associated with higher BMI and lower education.
Higher levels of phobic anxiety were also associated with higher leptin and sTNF- α receptor II in
both crude analyses and after adjustment for potential confounders. sICAM and sE-selectin were
higher in the highest tertile compared to the middle tertile but there was no significant trend
across tertiles. We found no association between phobic anxiety and adiponectin.
Conclusions: High levels of phobic anxiety are associated with increased levels of leptin and
inflammatory markers, which may in part explain the previously observed relationship between
anxiety and other psychosocial disorders with cardiovascular disease.
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