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Being one of the "worried well" might actually increase heart-disease risk, a study has suggested.

Norwegian researchers looked at health anxiety levels in 7,000 people who were followed for at least a decade.

The BMJ Open paper suggests that, while general anxiety is already recognised as a risk, health anxiety might also be an issue.

Heart experts said anyone who felt they were experiencing 'health anxiety' should speak to their doctor.

Health anxiety describes when people have a "persistent preoccupation" with having or acquiring a serious illness, and seeking prompt medical advice, without any symptoms of an actual disease.

Participants in this study were taking part in the Norwegian Hordaland Health Study (HUSK).

Dilemma

All were born between 1953 and 1957.

They completed questionnaires about health, lifestyle, and education and had blood tests, and their weight, height, and blood pressure measured regularly between 1997 and 1999.

They used a recognised scale called the Whiteley Index to assess anxiety levels.

The researchers also used national data to track hospital treatment and deaths in the group up to 2009.

And of the 7,000, 234 (3.3%) had a heart attack or bout of acute angina during the monitoring period.

Even after known risk factors were taken into account, the proportion of those succumbing to heart disease (just over 6%) was more than twice as high among the 710 considered to have health anxiety.

And the higher their anxiety score, the greater the risk of developing heart disease.

'Natural to worry'

Writing in BMJ Open, the researchers, led by Dr Line Iden Berge, said: "[Our research] further indicates that characteristic behaviour among persons with health anxiety, such as monitoring and frequent check-ups of symptoms, does not reduce the risk of [coronary heart disease] events.

"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 [coronary artery disease]."

Emily Reeve, a senior cardiac nurse at the British Heart Foundation, said: "It's natural for people to worry if they feel they might be unwell.

"But anxiety and stress can trigger unhealthy habits, such as smoking or eating badly, which put you at greater risk of heart disease.

"While we don't know if the 'worried well' are directly putting themselves at risk of a heart attack, it's clear that reducing unnecessary anxiety can have health benefits.

"If you are experiencing health anxiety, speak to your doctor."