Is there a link between mental illness and cardiovascular disease risk?

ENR October 7, 2019

A large study on over one million participants of military veterans finds an association between mental illnesses and an increased risk of cardiovascular disease.

A recent study assessed the association between mental illness severity and cardiovascular disease risk using a large sample database from a cohort of military veterans receiving care in the Department of Veterans Affairs. The study examined how psychiatric diagnosis (psychosis, bipolar disorder, depression, anxiety, and posttraumatic stress disorder) affected major cardiovascular disease outcomes over the course of 5 years, while controlling for parameters such as age, race, common cardiovascular risk factors (e.g., blood pressure, cholesterol), and antipsychotic and mood-stabilizer medications. In total, 1.5 million men and 94,000 women, aged 45 to 80 years, with no documented history of cardiovascular disease or clinical heart failure were included in the study.

The researchers found that depression, psychosis, and bipolar disorder were significantly correlated with an increased risk of cardiovascular disease, with the psychosis having the largest effect on both cardiovascular events and on mortality, in both genders. Some differences in gender and race were observed, with the anxiety associated with cardiovascular disease mortality only in men, and all mental illnesses having a less profound effect on the black population.

The researchers suggest that prior knowledge on which mental condition imposes the highest cardiovascular risk would help to estimate who would benefit from complementary treatment such as cholesterol-lowering drugs and blood pressure medications.

Although the findings are derived from a large sample size, a certain caution should be taken into consideration, as the cohort was based solely on data derived from veterans, which may not be consistent across the general population.

Written by Bella Groisman

References:

Mary C. Vance, MD, MSc Wyndy L. Wiitala, PhD Jeremy B. Sussman, MD, MS Paul Pfeiffer, MD, MS Rodney A. Hayward, MD, Increased Cardiovascular Disease Risk in Veterans with Mental Illness, October 2019, Circ Cardiovasc Qual Outcomes. 2019