Both cardiovascular and cerebrovascular disease are two of the leading causes of death and disease worldwide. Previous research has shown an association between mental disorders and increased risk of coronary heart disease and stroke. The association is present even after accounting for lifestyle behaviors such as alcohol intake, smoking, and history of illness. The relationship between mental and physical health is still not fully understood, previous studies have not looked at the association between psychological distress and cardiovascular disease occurrence, especially outside of examining mortality. A recent study published in Circulation: Cardiovascular Quality and Outcomes sought to address these gaps between psychological distress and cardiovascular diseases, such as heart attack and stroke, based on sex and age.
Cardiovascular disease encompasses a broad range of heart conditions that include diseased vessels, structural problems of the heart, and blood clots. Common mental disorders such as depression and anxiety, affect mood, thinking, and behavior. But the impact of one on the other is still poorly understood. Researchers from the University of Edinburgh in Scotland conducted a study in 221,677 participants from Australia. The participants had not experienced a heart attack or stroke at the start of the study; all individuals were over 45 between 2006 and 2009.
Analysis of participants included a 10-question survey including questions such as “How often do you feel tired for no good reason” or “How often do you feel so sad that nothing could cheer you up?”. Determination of psychological distress as low, medium and high/very high based on self-reporting was done for each participant. For 102,039 men, average age of 62, and 119,639 women, average age of 60, 16.2 percent reported moderate psychological stress and 7.3 percent had high/very high psychological distress.
The study found that among women, high/very high psychological distress was associated with a 44 percent increased risk of stroke and in men, high/very high psychological distress increase was associated with a 30 percent increased risk of heart attack. Over the four years 4,573 heart attacks and 2,421 strokes occurred, with the overall risk of heart and stroke rose with each level of psychological distress. The results add to the previous research that suggest an association between psychological distress and increased risk of cardiovascular disease. The study indicates that psychological distress has a strong dose-dependent association with stroke and heart attack that may be linked to sex differences. The association between cardiovascular disease and psychological distress persists despite a wide range of confounders and supports a direct mechanism linking psychological distress and cardiovascular disease.
Seeking medical help when exhibiting symptoms of psychological distress is important due to the impact on both mental and physical health. "We encourage more proactive screening for symptoms of psychological distress. Clinicians should actively screen for cardiovascular risk factors in people with these mental health symptoms," said Dr. Caroline Jackson, the study’s senior author and a Chancellor’s Fellow at the University of Edinburgh.
To learn more about psychological distress and cardiovascular disease watch the video below!