Fear of terrorism increases the risk of natural death

Terrorist attacks can lead to heart attacks later in life – for everyone.

Neuro-scientist Shani Shenhar-Tsarfaty studied the long term health effects of a person’s fear of terror. She and her team found that the perceived threat of terrorism can annually increase the pulse rate of healthy adults, and heighten their risk of cardiovascular diseases. In light of last week’s deadly terrorist attacks in Paris, Beirut and Baghdad, we ask Shani (Hebrew University of Jerusalem) to tell us more.

ResearchGate: What’s the connection between fear of terrorism, cardiac disease and premature death?

Shani Shenhar-Tsarfaty: Increased heart rate predicts cardiovascular and all-cause mortality. In our study we showed that fear of terror caused an annual increase in pulse, which can cause long term risk for cardiovascular diseases. The good thing is, we found that those at increased risk can benefit from therapeutic interventions to reduce heart rate.

RG: Who is at risk? Only those present at the time of the attack/s or the wider population? Why?

Shenhar-Tsarfaty: Fear of terror is universal and can have a major impact on the entire society. Our study searched for associations in the general population and not only on those individuals who were present at the time of the attack.

RG: What is the global significance of your study?

Shenhar-Tsarfaty: Unfortunately, today the risk from terror attacks has become global. Therefore, the relevance of this study may be global but would nevertheless depend on local findings. We focused on Israel in our study, which has been exposed to the repeated stress of multiple wars and terror attacks for more than 60 years.

Communities who live under such threats should realize that it imposes serious concerns on their health, and health authorities may wish to include such considerations in their work plans.

RG: How did you carry out this research, and why?

Shenhar-Tsarfaty: The Tel Aviv Medical Center Inflammation Survey (TAMCIS) follows 17,380 apparently healthy employees, attending a center for periodic health examinations, for a routine health examination. In this study we checked annual heart rate increases, and the mean time difference between two routine check-up's can vary between 1-3 years. Previous studies demonstrated that pulse values tend to decrease with age, and we thought to check what causes pulse increases.

The fear of terror score was based on 3 questions:

  1. “Nowadays, I worry about my personal safety."

  2. “Nowadays, I feel heightened tension when I am in crowded places."

  3. “I am afraid of a terror strike harming me or my family."


Our findings show consistent exposure to terror threats ignites fear. This can exacerbate preexisting stress related inflammation and pose a risk of heart attacks, strokes, as well as all-cause mortality at the population level.

Featured image courtesy of Guillaume Highwire

This story also appears in The Washington Post.