Healthgrades for Professionals

Empowering physicians with a patient perspective

How mental health conditions can increase heart attack, stroke risk in people under 40

A woman adjusts a string of lights outdoors
Experts say reducing stress can help people with mental health conditions. urbazon/Getty Images
  • Researchers say people under the age of 40 with mental health conditions have a higher risk of having a heart attack or stroke.
  • Experts say one of the key factors is the stress that can accompany mental health issues.
  • They add that many people with a mental health condition also adopt unhealthy lifestyle choices, such as poor diet and lack of exercise.

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

That’s according to a study Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source published today in the European Journal of Preventive Cardiology that looked at more than 6 million people. 

The study authors said in a press release that lifestyle behaviors didn’t explain the increased risk.

They noted that one of every eight people in the 20-to-39-year-old category had some kind of mental health condition. The issues included depression, anxiety, and insomnia. 

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

“The findings indicate that these individuals should receive regular health check-ups and medication if appropriate to prevent myocardial infarction and stroke,” Choi added. “While lifestyle behaviors did not explain the excess cardiovascular risk, this does not mean that healthier habits would not improve prognosis. Lifestyle modification should therefore be recommended to young adults with mental disorders to boost heart health.”

Details from the young adult mental health study

Researchers used the Korean National Health Insurance Service database, which covers the country’s entire population.

They looked at the association between mental health disorders in adults aged 20 to 39 years of age 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 health condition. Among those, nearly 48% had anxiety, 21% had depression, 20% had insomnia, nearly 28% had somatic system disorder, and more than 2% had substance use disorder. Less than two percent had bipolar disorder, schizophrenia, an eating disorder, personality disorder and/or post-traumatic stress disorder. 

Researchers followed the subjects until December 2018 for new-onset 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 health disorders and cardiovascular outcomes after adjusting for various factors.

They concluded that participants with any mental health disorder had a 58% higher likelihood of myocardial infarction and 42% greater risk of stroke compared to those with no mental health condition.

The link between mental and physical health

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

He told Medical News Today the study builds on decades of evidence saying mental health conditions 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 imbalances that can be caused by chronic stress and other mental health conditions,” Sultan said. 

He added the study highlights the need for a more integrated approach to healthcare that addresses both mental and physical issues.

“Healthcare systems should 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 conditions as well as increased collaboration between mental health providers and primary care physicians.  

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

The impact of stress on health

Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in California, told Medical News Today the study shows stress from mental health disorders can physically elevate the risk of heart disease. 

“Stress can trigger 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 physiologic changes over time that affect blood vessels, including increased oxidative stress, higher 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, told Medical News Today she was just explaining to a patient the connection between mental stress and the heart. 

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

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

“The heart is a muscle and being under constant stress will weaken your heart,” Parker said. “Stress increases blood pressure which puts the body in a higher category for heart attack and stroke. Stress also triggers unhealthy habits where one can overindulge with unhealthy eating. Preventative measures are therapy, working out, utilizing mindfulness meditation with breath work, and if needed one should ask about psychotropic medications.”

Michelle Giordano is a counselor and outreach specialist for nationwide substance abuse treatment centers Live Another Day. She told Medical News Today managing stress is key to lessening the risk. 

“This can entail learning stress-reduction strategies like mindfulness meditation, exercise, or counseling,” Giordano said. “Maintaining a healthy lifestyle, which includes routine exercise, a balanced diet, and abstaining from smoking and excessive alcohol use, is another important aspect.” 

She added it’s crucial for people to be upfront with their medical professionals about any physical symptoms they may be having as well as their worries regarding their mental health.  

“It’s critical to have an accurate diagnosis and treatment because mental health issues can occasionally present as physical symptoms,” Giordano said. “In order to spot and address any health issues early on, healthcare professionals can screen for both physical and mental health problems during routine checkups.”

Mental health and lifestyle factors

Tadwalkar noted mental health disorders can influence cardiovascular disease by increasing the probability of people adopting unhealthy behaviors, including smoking, excessive alcohol consumption, poor dietary choices, and sedentary lifestyle.

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

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

“People can take action to lower their risk of heart attacks and strokes as well as to enhance their general health and wellbeing by treating mental health issues and implementing healthy lifestyle practices,” added Giordano.

This article originally appeared on Medical News Today.

Was this helpful?
View All Healthgrades Pulmonology Professionals Articles
© 2004-2022 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.
MNT copyright image