Fear of Death In Heart Disease

Studies from all over the world have found that a fear of death is an indication of a healthy outcome in heart disease, especially in persons who have been diagnosed with atherosclerosis or who have had a heart attack, at least when people have the option of seeking medical treatment.

Sense of Impending Doom Leads to Seeking Effective Treatment

A Chinese study of patients who were already previously diagnosed with cardiovascular disease who had a sense of possible death found that they were 14 times more likely to seek admission to hospitals that could perform percutaneous cardiovascular interventions to put stents into clogged arteries than if they did not have a sense of impending doom. Patients who did not have a sense of imminent death were more likely to seek treatment with herbal medicine or medications. In other words, when you're scared that you're about to die, and that's actually a real risk, you are also more likely to do something that may reduce the real risk of dying. That step can, in turn, contribute to proving you wrong.

Sense of Impending Doom Leads to Cooperation with Treatment

A Japanese study of patients who survived a condition known as cardiac tamponade (the accumulation of fluid around the heart, interfering with its ability to beat) were highly likely to have used the terms and phrases "I am anxious," "I am discouraged," "I am depressed," or to have expressed a fear of death to their doctors. In this study, 89 percent of cardiac tamponade survivors, but a significantly smaller number of patients who later died of the disease, let their doctors know they were afraid they would die. Patients who are scared of death are more likely to be compliant with treatment recommendations. This, too, reduces their risk of death.

Cardioprotective Genes Also Trigger Fear Response

And on a very basic level, genes that help the heart overcome congestive heart failure also induce a fear response, at least in laboratory experiments with genetically engineered mice. Scientists at the European Molecular Biology Laboratory in Italy have found that genes that activate the release of two heart-protective hormones,  insulin growth factor isoform (mIGF-1) and the NAD+-dependent protein deacetylase (SIRT1), normalize blood pressure, but also increase evasive reactions to potentially dangerous stimuli. It is as if the mouse begins to protect its life once its heart is healthy enough to continue it.

At a very basic level, healthy hearts enable the body to respond to healthy fears. And at the level of choices in medical care, fear inspires heart patients to get the treatment they need--and even in developing countries, they usually do.

When is fear of death not an predictor of future health? People who don't have options don't benefit from fear. If care simply is not available, fear of death does not make life better. But when there are options for healthcare, a fear of death may be an ironically healthy kind of hypochrondria.