Cardiovascular Disease (CVD) and Mental Health: A Bidirectional Relationship

The heart is the powerhouse of our body, pumping blood to all our organs and keeping us alive. It is therefore of paramount importance to keep it healthy. We often associate cardiovascular disease (CVD) with physical risk factors such as high blood pressure, cholesterol, obesity, smoking, and a lack of exercise.1 However, there is a growing body of evidence that suggests that our mental health can also play a significant role in our risk of developing CVD.

Studies have found that people with CVD are at an increased risk of developing depression, and that depression is a risk factor for the development and progression of CVD.2 The link between CVD and depression is bidirectional, meaning that each condition can contribute to the other.2 For example, the physical symptoms of CVD can cause feelings of depression, while depression can lead to unhealthy behaviours that increase the risk of CVD.2

Impact of mental health on CVD risk

Mental health conditions including, but not limited to, depression, anxiety, and stress have all been linked to an increased risk of CVD.4 In fact, according to a press release issued this year by the European Society of Cardiology, the increase in risk of developing CVD is approximately 72% for individuals with major depressive disorders.4

So, why does our mental health have such a significant impact on our heart health? One reason is that mental health conditions can lead to unhealthy behaviours that increase the risk of CVD.5 For example, people who are depressed or anxious may be more likely to smoke, drink alcohol excessively, eat unhealthy foods, and be physically inactive.5

But mental health conditions can also cause physiological changes in the body that increase the risk of CVD.6 For example, chronic stress can cause the release of hormones such as cortisol and adrenaline, which can increase heart rate and blood pressure.6 Over time, this can lead to damage to the blood vessels and an increased risk of heart disease.6 Managing stress is therefore very important in helping reduce the risk of CVD. This can include practicing relaxation techniques such as deep breathing, meditation, or yoga.6

Whilst increased CVD risk is a result of certain mental health conditions, improving mental health can have a positive effect on heart health. Luckily, treatment options have proliferated in recent years as recognition of mental health has improved, and these can range from psychotherapy to medical intervention. A study published in the European Heart Journal found that people who received treatment for depression had a lower risk of developing CVD than those who did not.2

Impact of CVD on mental health

CVD can also have a significant impact on a person’s mental health, with a diagnosis often feeling frightening and potentially overwhelming.7 It can cause feelings of anxiety, depression, and stress. People with CVD may worry about their future health and quality of life, and they may feel a sense of loss or grief for the life they had before their diagnosis.7

Recognising and addressing the impact of CVD on mental health is an important part of managing the condition. This may include seeking treatment for mental health conditions, such as talking therapies or medication, as well as making lifestyle changes to reduce the risk of both CVD and mental health conditions. It is also important for healthcare providers to screen for and address mental health concerns in people with CVD, as untreated mental health conditions can negatively impact adherence to treatment and overall health outcomes.8 By taking a comprehensive approach to healthcare that addresses both physical and mental health, people with CVD can improve their quality of life and reduce their risk of further health complications.

It is now clear that mental health plays a significant role in the risk of developing CVD, and that CVD can have a detrimental impact on patient’s mental health. At Daiichi Sankyo Europe, we believe that improving CVD outcomes and preventing CVD, goes far beyond the medicines we can provide. We are exploring how a more holistic approach to CVD care can and should be implemented across Europe, that is why we recently published a report exploring the potential of a more holistic approach to CVD care. Read more here. (PDF)

References
[1] 
World Health Organization. Cardiovascular diseases (CVDs).
https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) Last Accessed September 2023.
[2] 
El Baou, C., et al. Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England. European Heart Journal. 2023. 18;(44): 1–14.
Last Accessed 
[3] 
Albus, C., et al. Significance of psychosocial factors in cardiology: update 2018. Clinical Research in Cardiology. 2019. 108: 1175-1196.
Last Accessed 
[4] 
European Society of Cardiology. Talking Therapies linked with reduced risk of cardiovascular disease.
https://www.escardio.org/The-ESC/Press-Office/Press-releases/talking-therapies-linked-with-reduced-risk-of-cardiovascular-disease Last Accessed September 2023.
[6] 
Harvard Health Publishing. Understanding the stress response.
https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response Last Accessed September 2023.
[7] 
British Heart Foundation. Heart disease and mental health.
https://www.bhf.org.uk/informationsupport/heart-matters-magazine/wellbeing/mental-health/mental-health-survey Last Accessed September 2023.
[8] 
Correll, CU., et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large‐scale meta‐analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017. 16;(2): 163-180.
Last Accessed