Prevention & lipidsMeta-analysis
Cardiac Anxiety in Adults with Cardiovascular Disease: Prevalence, Predictors, and Implications for Cardiac Rehabilitation - A Systematic Review
- Systematic review
- narrative synthesis
Authors' conclusion
HFA is prevalent across CVD diagnoses and was independently prognostic for adverse cardiovascular outcomes in two prospective cohorts. Several rehabilitation and psychological interventions were associated with HFA reductions, though the evidence remains largely observational.
Study context
- Population
- Adults with confirmed cardiovascular disease (CVD); heart-focused anxiety measured by Cardiac Anxiety Questionnaire (CAQ) or Herzangstfragebogen (HAF-17)
- Participants
- 9,628 adults · 26 studies
Pooled result
As reported in the abstract
Prevalence of clinically elevated HFA
Clinically elevated heart-focused anxiety (HFA), depending on population, timing of assessment and CAQ cut-off
15% to 49%
Further pooled results
HFA as predictor of MACE and mortality post-MI (2 prospective cohorts)
- HFA independently predicted MACE and mortality post-MI; avoidance the primary driver
- HR range 1.30-1.59
Correlates of HFA
- Associated with depressive symptoms, illness perception and impaired quality of life; suggested bidirectional relationship with physical inactivity
Interventions and HFA
- Standard cardiac rehabilitation (CR), specialised psychocardiological CR, device therapy and early mobilisation associated with reductions in HFA
Original publication
Cardiac Anxiety in Adults with Cardiovascular Disease: Prevalence, Predictors, and Implications for Cardiac Rehabilitation - A Systematic Review. Eur J Prev Cardiol. Published 28 September 2026. doi:10.1093/eurjpc/zwag509
Summarised from the published abstract; every number is checked against it