Patients with depression, anxiety more likely to experience heart attack, stroke

Middle-aged men and women with psychological conditions such as anxiety and depression are likely at an increased risk for cardiovascular complications, according to research out of Australia.

The large-scale study, spearheaded by Caroline Jackson, PhD, and published this week in Circulation: Cardiovascular Quality and Outcomes, involved 221,677 patients who were part of the New South Wales 45 and Up Study between 2006 and 2009. No participants had experienced MI or stroke prior to the trial.

Jackson, a Chancellor’s Fellow at the University of Edinburgh in Scotland, and her colleagues surveyed the study pool with a ten-question poll that asked participants to rate factors like how often they felt tired “for no good reason” or how frequently they’re so sad nothing can cheer them up. Psychological distress was categorized on a sliding scale as low, medium, high or very high, depending on that self-assessment.

A little more than 7 percent of participants reported very high psychological distress, Jackson et al. wrote, while 16.2 percent reported moderate distress. After more than four years of follow-up, the men and women had a total of 4,573 heart attacks and 2,421 strokes, with strokes slightly more common among women than men.

According to the research, high or very high psychological distress among women was associated with a 44 percent increased risk of stroke, and in men ages 45 to 79, high psychological distress was predictive of a 30 percent increased risk of heart attack.

The authors said the absolute risk of MI and stroke rose proportionately to the level of psychological distress a patient was experiencing. Risk rates remained similar regardless of lifestyle behaviors like smoking, drinking and diet.

“While these factors might explain some of the observed increased risk, they do not appear to account for all of it, indicating that other mechanisms are likely to be important,” Jackson said in a release from the American Heart Association.

The new research adds to a growing body of evidence suggesting there’s a link between psychological distress and adverse cardiovascular events, but Jackson said there needs to be more research before scientists can prove there’s a concrete tie. For now, she said, it’s important to reach out to those in psychological distress and encourage them to seek preventive help.

“We encourage more proactive screening for symptoms of psychological distress,” she said. “Clinicians should actively screen for cardiovascular risk factors in people with these mental health symptoms.”