Summary: New research links depression and poor mental health with a higher risk of cardiovascular disease and suboptimal heart health in young adults.
Source: Johns Hopkins Medicine
Young adults who report feeling depressed or experiencing frequent poor mental health days face a greater likelihood of developing cardiovascular disease (CVD) and exhibiting poorer overall heart health, according to a large study led by researchers at Johns Hopkins Medicine. The analysis evaluated responses from more than half a million people aged 18 to 49 and highlights the importance of mental health for long-term cardiovascular outcomes.
The findings add to growing evidence that depression and other mental health problems are associated with heart disease in younger and middle-aged adults, suggesting that this relationship may begin in early adulthood rather than emerging only later in life.
Published Jan. 23 in the Journal of the American Heart Association, the study found that young adults who self-reported depression or multiple days of poor mental health had higher rates of heart attacks, strokes and established risk factors for heart disease compared with peers who did not report mental health problems.
“When you’re stressed, anxious or depressed, it’s common to experience a raised heart rate and higher blood pressure. Those feelings also often lead to lifestyle choices—such as smoking, excess alcohol use, inadequate sleep and low physical activity—that harm cardiovascular health,” says Garima Sharma, M.B.B.S., associate professor of medicine at Johns Hopkins Medicine and senior author of the study.
The research team analyzed responses from 593,616 adults who took part in the Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative, self-reported survey conducted between 2017 and 2020. Participants answered questions about a history of diagnosed depressive disorder, the number of poor mental health days they experienced in the past month (0 days, 1–13 days, or 14–30 days), any history of heart attack, stroke or angina, and the presence of cardiovascular risk factors.
Risk factors considered in the study included high blood pressure, high cholesterol, overweight or obesity, smoking, diabetes, and inadequate physical activity and diet. The investigators defined suboptimal cardiovascular health as having two or more of these risk factors.
Overall, about one in five participants reported a history of depression or frequent episodes of feeling low. The researchers note that rates of depression and poor mental health may have risen during the study’s final year, which overlapped with the first year of the COVID-19 pandemic. According to the U.S. Centers for Disease Control and Prevention, the share of U.S. adults reporting symptoms of depression or anxiety increased from 36.4% to 41.5% during the pandemic’s first year, with the largest rise among people aged 18 to 29.
The study found a clear, graded association between the number of poor mental health days and cardiovascular disease. Compared with participants reporting no poor mental health days in the past 30 days, those reporting 1–13 poor mental health days had approximately 1.5 times the odds of CVD, while participants reporting 14–30 poor mental health days had about double the odds. These associations persisted after adjusting for sociodemographic factors and traditional cardiovascular risk factors and did not vary significantly by sex or by urban versus rural residence.
“The relationship between depression and heart disease is bidirectional: depression can increase the likelihood of heart disease, and people living with heart disease are at elevated risk for depression,” says Yaa Adoma Kwapong, M.D., M.P.H., a postdoctoral research fellow at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease and lead author of the study.
Kwapong notes that these findings support prioritizing mental health care for young adults and suggest that clinicians might consider more routine screening for cardiovascular risk in patients with mental health conditions—and, conversely, assessing mental health in young adults with cardiovascular risk factors—to improve long-term heart health.
The investigators caution that their analysis provides a cross-sectional snapshot rather than evidence of causation. They recommend longitudinal studies to follow young people over time and better understand how depression and poor mental health influence the development and progression of cardiovascular disease.
About this depression and CVD research news
Author: Press Office
Source: Johns Hopkins Medicine
Contact: Press Office – Johns Hopkins Medicine
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Original Research: Open access. “Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States” by Yaa A. Kwapong et al., Journal of the American Heart Association
Abstract
Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States
Background
Depression is increasingly recognized as a nontraditional risk factor for cardiovascular disease. However, data examining how depression and poor mental health relate to CVD and suboptimal cardiovascular health (CVH) in young adults have been limited. This study sought to clarify those associations in a large, nationally representative sample.
Methods and Results
The analysis used BRFSS data from 593,616 adults aged 18–49 collected from 2017–2020. Exposures included self-reported history of depression and the number of poor mental health days in the past 30 days (categorized as 0, 1–13, and 14–30 days). Outcomes were self-reported cardiovascular disease (myocardial infarction, angina, or stroke) and suboptimal CVH, defined as the presence of two or more cardiovascular risk factors (hypertension, high cholesterol, overweight/obesity, smoking, diabetes, physical inactivity, and inadequate fruit and vegetable intake).
After adjusting for sociodemographic characteristics and, when appropriate, cardiovascular risk factors, people with a history of depression had higher odds of CVD (odds ratio [OR], 2.32). The weighted prevalence of depression in the sample was 19.6%, and the weighted prevalence of CVD was 2.5%. There was a graded relationship between the number of poor mental health days and both CVD and suboptimal CVH. Compared with individuals reporting 0 poor mental health days, those with 1–13 days had an OR of 1.48 for CVD, and those with 14–30 days had an OR of 2.29. Depression was also associated with greater odds of suboptimal CVH (OR, 1.79).
Conclusions
Depression and frequent poor mental health days are associated with premature cardiovascular disease and with suboptimal cardiovascular health among young adults. While the relationship is likely bidirectional, these results underscore the need to prioritize mental health as part of efforts to reduce cardiovascular risk and improve heart health in younger populations.