How mental illness can increase the risk of heart attack and stroke

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Experts say reducing stress can help people with mental health problems. urbazon/Getty Images
  • Researchers say people under the age of 40 with mental illness are at higher risk of heart attack or stroke.
  • Experts say one of the key factors is stress, which can accompany mental health problems.
  • They add that many people with mental health problems also adopt unhealthy lifestyles, such as poor diet and lack of exercise.

People in their 20s and 30s who have mental health problems are up to three times more likely to have a heart attack or stroke.

This is according to a study published today in European Journal of Preventive Cardiology which have been viewed by more than 6 million people.

The study authors said in a news release that lifestyle behaviors do not explain the increased risk.

They noted that one in eight people in the 20 to 39 age group had some type of mental illness. Problems include depression, anxiety and insomnia.

“Psychological problems are common in young adults and have a strong relationship with cardiovascular health,” Eue-Keun Choi, study author and professor at Seoul National University College of Medicine in South Korea, said in a press statement.

“The findings suggest that these individuals should receive regular health checkups and medication as needed to prevent myocardial infarction and stroke,” added Choi. “Although lifestyle behaviors do not explain increased cardiovascular risk, this does not mean that healthier habits will not improve prognosis. Therefore, lifestyle modification should be recommended for young people with mental disorders to improve heart health.

The researchers used the database of the Korean National Health Insurance Service, which covers the entire population of the country.

They looked at the relationship between mental disorders in adults aged 20 to 39 and the risks of developing myocardial infarction and ischemic stroke.

The study focused on subjects who had health examinations between 2009 and 2012 and had no history of myocardial infarction or stroke. The average age was 31 years and 58% of participants were 30 years or older.

More than 13% of participants had at least one mental illness. Among them, almost 48% had anxiety, 21% had depression, 20% had insomnia, nearly 28% had a somatic disorder, and more than 2% had a substance use disorder. Less than two percent had bipolar disorder, schizophrenia, an eating disorder, a personality disorder, and/or PTSD.

The researchers followed the subjects until December 2018 for new myocardial infarction and stroke. During a median follow-up of more than 7 years, there were 16,133 myocardial infarctions and 10,509 strokes.

The authors analyzed the association between mental disorders and cardiovascular outcomes after adjusting for various factors.

They concluded that participants with any mental disorder had a 58% higher likelihood of myocardial infarction and a 42% greater risk of stroke compared to those without a mental illness.

Dr. Ryan Sultan is a psychiatrist and researcher at Columbia University in New York.

He said Medical News Today the study builds on decades of evidence that mental states affect the rest of the human body.

“The link between mental health conditions and physical health problems is not just due to neglect or poor self-care. It is also due to biological factors such as inflammation and hormonal imbalance, which can be caused by chronic stress and other mental conditions,” Sultan said.

He added that the study highlights the need for a more integrated approach to health care that addresses both mental and physical problems.

“Health care systems must adopt a holistic approach that recognizes the interplay between mental and physical health,” Sultan said. “This could include routine mental health screenings for patients with chronic physical illnesses, as well as increased collaboration between mental health providers and primary care physicians.”

“Furthermore, addressing the social determinants of health such as poverty, access to health care and discrimination can help reduce the burden of mental and physical health problems,” he added.

Dr. Rigved Tadwakar, a cardiologist at Providence St. John’s Health Center in California, said Medical News Today the study shows that the stress of mental disorders can physically increase the risk of heart disease.

“Stress can cause dysfunction of the autonomic nervous system, causing the release of stress hormones like cortisol,” Tadwalkar said. “This leads to higher blood pressure, but can also cause other physiological changes over time that affect blood vessels, including increased oxidative stress, greater inflammatory burden, and endothelial dysfunction, promoting the development of atherosclerosis and heart disease.” .”

Kimberly Parker, a licensed therapist at Healthy Mind Counseling & Nutrition in Newport News, Virginia, said Medical News Today she was simply explaining to a patient the connection between mental stress and the heart.

“High levels of stress produce large amounts of cortisol and adrenaline,” Parker said. “When the brain activates fight or flight mode over time, it causes emotional and physical fatigue. The symptoms that come along with this are lack of sleep, which causes stress on the mind and body.

Parker added that the constant stress of a mental disorder takes its toll on the heart.

“The heart is a muscle, and constant stress will weaken your heart,” Parker said. “Stress raises blood pressure, which puts the body in a higher category for heart attack and stroke.” Stress also triggers unhealthy habits where a person may overeat with unhealthy eating. Preventive measures are therapy, exercise, use of mindfulness meditation with breath work and, if necessary, one should ask for psychotropic medication.

Michelle Giordano is a counselor and outreach specialist for national substance abuse treatment centers. Live another day. She said Medical News Today stress management is key to reducing risk.

“This could lead to learning stress-reduction strategies, such as mindfulness meditation, exercise or counseling,” Giordano said. “Maintaining a healthy lifestyle that includes regular exercise, a balanced diet and refraining from smoking and excessive alcohol use is another important aspect.”

She added that it is extremely important that people are open with their healthcare professionals about any physical symptoms they may have, as well as their concerns about their mental health.

“It’s extremely important to have an accurate diagnosis and treatment because mental health issues can sometimes manifest as physical symptoms,” Giordano said. “To detect and address any health problems at an early stage, health professionals can check for both physical and mental problems during routine check-ups.”

Tadwalkar noted that mental disorders can influence cardiovascular disease by making people more likely to engage in unhealthy behaviors, including smoking, excessive alcohol consumption, poor dietary choices and a sedentary lifestyle.

“This can lead to the development of conditions such as hypertension, hyperlipidemia or diabetes mellitus, all of which are risk factors for heart disease,” he said.

Tadwalkar noted that another consideration is that “people with mental disorders are usually maintained on medications that can have side effects that impact cardiovascular health.”

“People can take action to reduce their risk of heart attacks and strokes and improve their overall health and well-being by treating mental health issues and implementing healthy lifestyle practices,” Giordano added.

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