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Hypochondriacs who constantly fret about their health without any real reason could actually be putting themselves at greater risk of heart disease.

That is the finding of a group of Norwegian researchers, who studied ‘health anxiety’ levels in 7,000 people over a 10-year period. The term ‘health anxiety’ describes people who have a persistent preoccupation with having or getting a serious illness, and who seek medical advice without any symptoms of an actual diseases.

All the participants in the Norwegian study were born between 1953 and 1957. They filled in questionnaires about health, lifestyle and education and underwent regular medical checks. The researchers also used a recognised scale to measure their health anxiety levels, finding that just over 10% of the study group could be classified as having it to varying degrees. They then continually monitored their health of the entire group.

Even after known risk factors were taken into account, the number of those succumbing to heart disease in the ‘health anxiety’ section of the study group was more than twice as high as in the rest of the group. More than that, of the 710 people in the health anxiety group, the study results showed a correlation between the severity of their anxiety and the likelihood of developing heart disease. In other words, the more anxious they were, the more likely they were to get it.

Doctors have long known that general anxiety can be a contributory factor in many health conditions, both physical and mental. But the Norwegian study is more precise. It suggests that people who can be measured as having health anxiety by a recognised method (called the Whiteley Index) are at a significantly greater risk of developing a particular condition – heart disease.

“You’ll make yourself ill with worry” is a well-worn phrase, but the study suggests that like many such sayings, it is grounded in fact. It is a bitter irony though, that people who continually worry about their health when they are actually well are more likely to make themselves seriously unwell. It is what’s known as a ‘self-fulfilling prophecy’.

The answer seems obvious – simply not to worry about your health – but that is easier said than done. Some people are natural worriers, and hypochondria is a recognised psychiatric condition requiring lengthy and complex treatment. Part of the problem is that hypochondriacs will worry about getting ill, make themselves ill with worry, then take that illness as evidence that they were right to be worried all along.  In this way the condition reinforces itself.

Some people who suffer from constant health anxiety might also seek to ease it through activities such as smoking, eating unhealthily, drinking too much or even taking non-prescription medicines when they are not needed. Over time all these things can lead to serious illness and, in particular, heart disease.

One of the Norwegian researchers, Dr Line Iden Berge, wrote in the British Medical Journal that: “These findings illustrate the dilemma for clinicians between reassuring the patient that current physical symptoms of anxiety do not represent heart disease, contrasted against the emerging knowledge on how anxiety, over time, may be causally associated with increased risk of heart disease."

The advice for people who suffer from health anxiety is to see their doctor. Not about any imaginary condition which is causing their anxiety, but about the anxiety itself. Addressing the underlying and very real anxiety, rather than the phantom illness it is focused on, might actually prevent a genuine illness from developing.

And the Norwegian study also puts a fresh impetus on medical professionals to consider how they deal with supposed hypochondriacs. Saying “it’s all in your head” and sending a patient away is simply not enough. Medical professionals must realise that what is ‘in a patient’s head’ is in itself a condition which needs to be treated. If left untreated, it could well lead to a condition which is definitely not all in their head.

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