A new report from Emory University, published in The Lancet Regional Health-Europe, reveals that individuals with mental health conditions face a 50% to 100% higher risk of developing heart disease-and a 60% to 170% higher risk of poor outcomes if they already have cardiovascular disease (CVD). This metareview, led by Dr. Viola Vaccarino, MD, PhD, is part of a broader effort to highlight disparities in heart health across women, the elderly, racial minorities, and those with mental illness.
The Emory team analyzed data linking major mental health conditions—including depression, anxiety, bipolar disorder, PTSD, and schizophrenia—to increased cardiovascular risk. The report found the following associated increases: 72% for major depression, 57% for PTSD, 61% for bipolar disorder, 50% for panic disorder, 70% for phobic anxiety, and nearly 100% for schizophrenia.
The researchers also emphasized a two-way relationship. “More than 40 percent of those with cardiovascular disease also have a mental health condition,” says Dr. Vaccarino.
The report highlights biological links between mental health and heart disease, focusing on the role of the autonomic nervous system (ANS) and the hypothalamic-pituitary adrenal axis (HPA). These systems, when dysregulated, can lead to inflammation, metabolic issues, high blood pressure, and other risk factors for heart disease.
Social determinants also play a role. Barriers like affordability, limited access to care, and stigma often disrupt care for people with mental illness. Mental health conditions are rarely considered in cardiovascular risk prediction models and are frequently excluded from clinical trials.
“The tight connection between cardiovascular and psychological health warrants changes in the health care system that are more amenable to patients with comorbidities,” says Dr. Vaccarino.
Ultimately, the report calls for healthcare reform that recognizes the rights of people with mental illness to achieve equitable health outcomes through integrated, interdisciplinary care.
Reference: Mental health disorders and their impact on cardiovascular health disparities, Vaccarino, Viola et al. The Lancet Regional Health – Europe, Volume 56, 101373
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