Adults with high levels of anxiety and depression have up to 30% greater risk of heart attack and 44% greater risk of stroke, based on results of an Australian study recently published in Circulation: Cardiovascular Quality and Outcomes.
Known as the “New South Wales 45 and Up Study,” this study surveyed nearly 222,000 Australian adults about their mental health and then followed them for an average of five years. The goal was to see whether adults reporting psychological distress had greater risk for heart events, as other studies have suggested.
As part of the study, researchers surveyed participants about their mental health using a simple 10-item questionnaire called the Kessler Psychological Distress Scale. The survey is used to assess levels of anxiety and depression, which are known risk factors for heart disease.
The exam includes questions such as “During the past four weeks, how often did you feel nervous, hopeless, depressed, worthless or tired out for no good reason?”. Answers range from none of the time (1 point) to all of the time (5 points), with a higher total score indicating higher levels of anxiety and depression.
Among the 221,677 study participants, 16% reported moderate anxiety and depression and 7% reported high to very high levels of distress. Researchers noted that women were more likely to report moderate or high levels of anxiety and depression than men. Authors also found that anxiety and depression were more common in younger adults, as well as low-income adults and those with poorer health and lifestyle choices.
After following participants for nearly five years, there were a total of 4,573 heart attacks and 2,421 strokes. Researchers found that participants with higher levels of anxiety and depression had significantly greater risk of heart events than those with better mental health.
Overall, men with high levels of anxiety and depression had 30% greater risk of heart attack and 24% greater risk of stroke than men with no distress. Similarly, women with high levels of anxiety and depression had 18% greater risk of heart attack and an estimated 44% greater risk of stroke than women with no distress.
The average age of participants was between 60 and 62 years old and all were free of heart disease at the start of the study.
What findings confirm, according to authors, is the close connection between mental and physical health. Stress, anxiety and depression are well known risk factors for heart disease—the No. 1 killer of Americans. Experts note that it’s important to consider mental health right alongside other well-established risk factors like high blood pressure and high cholesterol.
Authors also encourage future research on the issue, as the connection between mental health and heart health is still poorly understood.