Depression, anxiety spur poor health habits, damaging heart and blood vessels

December 15, 2008

Anyone will tell you that stress is bad for the heart. Many people also know about the toxic effects of anxiety and depression. But how exactly do these negative emotions cripple the cardiovascular system--and what can be done about it?

New research published in the December 16/23, 2008, issue of the Journal of the American College of Cardiology (JACC) offers some answers. It shows that many people who experience psychological distress also slip into poor health habits, particularly smoking and physical inactivity. Over several years, these two factors alone may account for nearly two-thirds of the risk of heart attack and other cardiovascular illnesses in people with depression and anxiety.

"Psychological distress is a growing problem," said Mark Hamer, Ph.D., a senior research fellow at University College London, UK. "It's very important that physicians try to identify psychological distress, but it's also important to look at the behaviors and the risk factors that are associated with it."

Previous studies have established the link between psychological distress and heart disease, but so far there is insufficient evidence to show that treating depression and anxiety can reduce the risk of heart attack and death. The new research findings suggest a broader approach may be necessary.

"Treating psychological factors on their own might not be the best way," Dr. Hamer said. "We're suggesting that you might have to intervene in the more intermediate pathways, which is the behavior, in addition to trying to treat the psychological problems."

For the new study, researchers recruited 6,576 men and women who were participating in the Scottish Health Survey, a population-based study involving a typical group of people living in Scotland. At the beginning of the study, participants completed a 12-item standardized questionnaire designed to measure their general happiness, symptoms of depression or anxiety, and any recent sleep disturbances. Those with a score of 4 or more--approximately 15 percent of those participating in the study--were considered to be suffering from psychological distress.

At the same time a nurse took a blood sample that was later tested for common physical risk factors for heart disease, such as cholesterol and C-reactive protein (CRP), a marker of arterial inflammation. Researchers also collected information on height, weight, physical activity, alcohol intake and smoking, and had access to each participant's medical history, including information on blood pressure.

Researchers followed-up study participants for an average of more than 7 years, using hospital records to document death from heart disease, as well as the rate of heart attack, stroke, cardiac bypass surgery and coronary interventions (e.g., angioplasty). Over that time, there were a total of 223 such cardiovascular "events," including 63 deaths.

Researchers found a significant and direct link between increasing psychological distress and increasing risk of cardiovascular illness and death. In fact, after age and sex were taken into account, people with depression and anxiety faced more than a 50 percent increased risk when compared to happier people.

However, when the researchers included unhealthy behaviors in the analysis, they found that smoking and physical inactivity alone explained approximately 63 percent of the increased cardiovascular risk. (Smoking had the greatest impact, accounting for nearly 41 percent of the risk.) Alcohol intake explained less than 2 percent of the risk, while high blood pressure explained 13 percent and CRP explained just under 6 percent.

"This study helps us to better understand the relative contributions of stress-related changes in behavior and physiology leading to heart disease," said Roland von Känel, M.D., a professor of medicine and psychiatry, and head of the psychocardiology unit of the Swiss Cardiovascular Center at the University Hospital of Bern, Switzerland. Dr. von Känel did not participate in the study but was invited to write an editorial comment in the same issue of JACC.

"From a public health perspective, the findings encourage us to emphasize broad preventive strategies to target the behavioral and physiological pathways leading from stress to cardiovascular disease," he said. "These may span from behavioral interventions targeting smoking cessation and increasing physical activity, to stress management and relaxation techniques previously shown to restore cardiovascular function and to reduce inflammation. Whether such interventions ultimately decrease the cardiovascular risk associated with psychological distress needs further study."
-end-
The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 36,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.acc.org .

The American College of Cardiology (ACC) provides these news reports of clinical studies published in the Journal of the American College of Cardiology as a service to physicians, the media, the public and other interested parties. However, statements or opinions expressed in these reports reflect the view of the author(s) and do not represent official policy of the ACC unless stated so.

American College of Cardiology

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.