Young adults with depression and poor mental health are more likely to develop cardiovascular disease

Young adults who feel down or depressed are more likely to develop cardiovascular disease (CVD) and have poor heart health, according to a new study led by Johns Hopkins Medicine researchers who analyzed data from more than half a million people between the ages of 18 and 49. The findings add to a growing body of evidence linking CVD to depression among young and middle-aged adults and suggest that the link between the two may begin in early adulthood.

The study, published on January 23 in Journal of the American Heart Associationalso found that young adults who self-reported feeling depressed or having bad mental health days had higher rates of heart attacks, strokes, and heart disease risk factors than their peers without mental health problems.

When you are stressed, anxious or depressed, you may feel overwhelmed and your heart rate and blood pressure increase. It is also common that feeling down can lead to poor lifestyle choices such as smoking, drinking alcohol, less sleep and lack of physical activity -; all adverse conditions that negatively affect your heart.”

Garima Sharma, MBBS, associate professor of medicine at Johns Hopkins Medicine and senior author of the study

Sharma and her colleagues looked at data from 593,616 adults who participated in the Behavioral Risk Factor Surveillance System, a nationally representative study conducted between 2017 and 2020. The study included questions about whether they had ever been told they had a depressive disorder , how many days they had poor mental health in the past month (0 days, 1–13 days, or 14–30 days), whether they had experienced a heart attack, stroke, or chest pain, and whether they had cardiovascular disease risk factors.

Risk factors include high blood pressure, high cholesterol, overweight/obesity, smoking, diabetes, and poor physical activity and diet. People who had two or more of these risk factors were considered to have suboptimal cardiovascular health.

One in five adults self-reported depression or often feeling down, with the study noting that rates may have been higher in the last year of the study, which was the first year of the COVID-19 pandemic. According to the US Centers for Disease Control and Prevention, the percentage of US adults who have experienced depression or anxiety jumped from 36.4% to 41.5% in the first year of the pandemic, with the highest jump among people aged 18 to 29 years.

The study found that overall, those who self-reported feeling down for several days had a stronger association with cardiovascular disease and poor heart health. Compared with people who reported no days of poor mental health in the past 30 days, participants who reported up to 13 days of poor mental health had 1.5 times the odds of CVD, while those with 14 or more days of poor mental health had double the odds. Associations between poor mental health and CVD did not differ significantly by gender or urban/rural status.

“The relationship between depression and heart disease is a two-way street. Depression increases the risk of heart problems, and those with heart disease experience depression,” said Yaa Adoma Kwapong, MD, MPH, a postdoctoral fellow at the Johns Hopkins Ciccarone Center for Cardiovascular Disease Prevention and lead author of the study. “Our study suggests that we need to prioritize mental health among young adults and perhaps increase screening and monitoring for heart disease in people with mental illness, and vice versa, to improve overall heart health.”

Kwapong says this new study only provides a snapshot of cardiovascular health among young people with depression, and that new studies should look at how depression affects cardiovascular health over time.

Other researchers include Ellen Boaki, Sadia Khan, Michael Honigberg, Seth Martin, Chigolum Oyeka, Alison Hayes, Pradeep Natarajan, Mamas Mamas, Roger Blumenthal, and Michael Blaha.

Partial funding for this study came from the American Heart Association.


Journal reference:

Quapong, Y.A., et al. (2023) Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States. Journal of the American Heart Association.

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