Mental Health Disorders Double the Risk of Heart Disease or Stroke
Depression has long been understood as something that can wear a person down for years, sometimes for a lifetime. What newer research keeps showing is how far its reach extends past mood and into the body. Earlier work had already tied mental health conditions to a greater likelihood of cardiovascular trouble and coronary artery disease. A study presented at the Canadian Cardiovascular Congress pushed that connection further. Dr. Katie Goldie, the lead author and a postdoctoral fellow at the Centre for Addiction and Mental Health in Toronto, found that people dealing with mental illness carry a markedly higher chance of heart disease or stroke.
Goldie and her colleagues pulled from the Canadian Community Health Survey. They looked at people living with schizophrenia, bipolar disorder, major depression and anxiety disorders, hoping to sharpen the picture of how mental illness and heart risk overlap. The team tracked which medications participants were taking: antipsychotics, benzodiazepines, mood stabilizers and antidepressants. They also recorded how often cardiovascular events showed up among the group.
Three findings stood out. Anyone who had experienced a mental health disorder at any point in life was twice as likely to have had heart disease or a stroke. Among those who had not yet developed either, the long-term odds of cardiovascular disease still ran higher than in the general population. And people on psychiatric medication were twice as likely to have heart disease and three times as likely to have had a stroke compared with people not taking those drugs.
Why would something like depression translate into so much more heart trouble? The researchers pointed to several overlapping reasons. Goldie noted that people living with mental illness often fall into habits that raise their risk: poor diet, smoking, alcohol, little exercise. She gave one striking comparison. Roughly 20 percent of Canadians smoke, but among people with a diagnosed mental health condition the figure runs anywhere from 40 to 90 percent. That gap is hard to ignore.
Medication carries part of the load too. Many psychiatric drugs are linked to weight gain and interfere with how the body processes fats and sugars, which can open the door to obesity, high cholesterol and diabetes. There is also the matter of access and communication. People with mental health disorders sometimes struggle to talk about what they are going through, and the illness itself can keep them from seeking help at all. "A separation between primary and mental health services can also challenge these patients' care," Goldie said. "We need improved integration and collaboration."
When a condition becomes disabling, a patient may simply not be able to reach for medical help. Stigma compounds the problem, and it can creep into the care providers themselves offer. Goldie noted that patients with these disorders are less likely to receive treatments that lower cardiovascular risk, and less likely to undergo procedures such as bypass surgery.
The evidence tying mental and physical health together keeps growing, which makes the case for treating both at once. People need care for their psychiatric conditions and attention to their physical health from medical professionals. Clinicians, for their part, could be more proactive with these patients: routine cardiovascular assessments before and during any course of psychiatric medication, along with practical guidance on cutting heart risk.
Ongoing medical care matters here, not just psychiatric care. Too often an at-risk patient sees a psychiatrist who prescribes medication without ordering follow-up lab work or tracking what the drugs are doing to the body. The point is not to stop the medication. For most people the benefits outweigh the risks. It is about watching more closely, with regular follow-ups shared between a primary physician and a mental health provider so that overall health stays in view.
The link between mental health disorders and the risk of heart disease and stroke is real and strong.
Reported by Laura Wells. Source: Heart and Stroke Foundation of Canada. (2014, October 27). People with mental health disorders twice as likely to have heart disease or stroke. ScienceDaily. Retrieved December 1, 2014 from www.sciencedaily.com/releases/2014/10/141027085432.htm