Mental Health Can Affect Your Heart

Anxiety and depression may predict new onset of heart disease

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Many physical health and lifestyle factors are considered when determining a person's risk of heart disease. Did you know that your mental health history could be equally as important?

A recent study looked at the relationship between depression and anxiety and heart disease. The researchers focused on middle-aged women who had a history of both depression and anxiety disorders and no history of heart disease.

Findings from this study showed that the combination of anxiety and depression could be an important factor in the development of heart disease. The authors argued that factors like lifestyle, physical health and age cannot solely determine the possible development of heart disease.

The study concluded that mental health, especially the combination of depression and anxiety, is associated with heart problems. The authors of this study suggested that doctors and patients should consider mental health when evaluating risk for heart disease.

"Tell your doctor if you have any anxiety or depression symptoms."

This study was conducted through the School of Population Health of the University of Queensland in Queensland, Australia. Samantha J. McKenzie, PhD, professor in the School of Population Health, was the lead author.

Participant data came from a previous study called the Australian Longitudinal Study on Women's Health. There were six surveys given to three different age groups of women over the course of 15 years starting in 1996.

The researchers of the current study used this survey data to determine if a history of combined depression and anxiety could predict the risk of developing heart disease.

Mental health is believed to be connected to heart health, but the authors of this study explained that there has not been a study that has investigated the specific association between the new onset of heart disease and a history of both anxiety and depression.

This study focused on 11,828 middle-aged women out of the group of women born between 1946 and 1951 who had answered 'no' to the question, "Have you ever been told by a doctor that you have heart disease?" on the first two surveys in 1996 and 1998.

The researchers then looked for the women who reported being diagnosed or treated for heart disease in any of the surveys given from 2001 to 2010. These women were considered to have new onset of heart disease.

The surveys also considered psychological history of doctor-diagnosed anxiety and depression; health factors such as high blood pressure, diabetes and menopausal status; lifestyle factors such as level of exercise and smoking status; and data on age, marital status, level of education and ability to manage on a given level of income.

The authors analyzed the data and used two different models to calculate the connection between heart disease and combined depression and anxiety.

One of the models did not consider any other factors other than the data on heart disease and combined diagnosis of depression and anxiety. The second one considered all the data, adjusting for all the outside factors that might contribute to heart disease.

The study's findings suggested that women with new onset of heart disease were more likely to have a mental history of combined anxiety and depression compared to women who did not experience heart disease.

New cases of heart disease were rare in this study. By the end of the study, 2.3 percent of all the women had developed new cases of heart disease. However, women with anxiety and depression were 1.78 times more likely to develop heart disease than women without these mental health issues.

The researchers determined that the new onset of heart disease is connected to a history of combined anxiety and depression in middle-aged women. Other potential risk factors having to do with health status, lifestyle and sociodemographic data (age, marital status, etc.) could not fully explain and predict new onset of heart disease.

The study explained that both of these mental health conditions can directly affect the cardiovascular system (heart and blood vessels) by affecting nervous system activity. Poor mental health is also known to indirectly lead to poor heart health through unhealthy behaviors such as low levels of exercise or increased smoking.

The authors of this study reported a few possible limitations of their research.

First, both poor mental health and future heart issues could be caused by undiagnosed subclinical manifestations (asymptomatic or not characterized by normal symptoms) of heart disease. The researchers noted that the current study was unable to adjust for this possibility.

Second, the researchers had to rely on self-reported diagnoses of anxiety and depression, and some of the women may never have sought out psychological help. The authors thought that this could have meant the relationship between combined anxiety and depression and heart disease is stronger than presumed.

Therefore, the authors of this study believe that it is especially necessary for female patients and doctors to discuss the patient's mental health history when determining heart disease risk.

This study was published in the August edition of the Journal of Behavioral Medicine.

This study was funded by both a Cardiovascular Disease and Depression Strategic Research Grant from the National Heart Foundation of Australia and beyondblue, an Australian depression initiative. The Australian Government Department of Health and Aging provided funding for the Australian Longitudinal Study on Women's Health.

Review Date: 
August 7, 2013
Last Updated:
August 9, 2013