Summary: New research highlights a strong link between mental health and cardiovascular disease. Depression, anxiety and chronic stress are associated with earlier development of heart disease risk factors and a higher likelihood of major cardiac events.
Two preliminary studies presented at the American Heart Association’s Scientific Sessions 2023 show that psychological conditions do more than affect mood—they also influence physical processes that increase the risk of heart attack, stroke and other cardiovascular problems. These findings support more proactive cardiovascular screening and stress management for people with mental health concerns.
Key Facts:
- Anxiety and depression were linked to an average six-month earlier onset of new cardiovascular risk factors.
- Individuals with depression or anxiety had about a 35% higher risk of major cardiovascular events, such as heart attack and stroke.
- Greater cumulative perceived stress correlated with a 22% higher risk of atherosclerosis and a 20% higher risk of overall cardiovascular disease, independent of traditional risk factors.
Source: American Heart Association
Overview
The heart and the mind are closely connected. Two independent studies presented at the American Heart Association’s Scientific Sessions 2023 explored how depression, anxiety and ongoing stress influence the timing and development of cardiovascular risk factors and events. Both studies reinforce the importance of integrating mental health assessment into cardiovascular prevention and care.
Depression and anxiety accelerate the development of cardiovascular risk factors (MDP274)
The first study investigated a potential mechanism linking psychological conditions to increased cardiovascular disease risk. Researchers used data from the Mass General Brigham Biobank, following adults without prior heart events over a decade to determine how quickly new cardiovascular risk factors appeared.
Key findings included:
- 38% of participants developed at least one new cardiovascular risk factor—such as high blood pressure, elevated cholesterol or type 2 diabetes—during follow-up.
- People with a prior diagnosis of anxiety or depression developed a new risk factor on average six months earlier than those without these conditions.
- Depression and anxiety were associated with approximately a 35% greater risk of a major cardiovascular event (heart attack or stroke).
- About 40% of the increased risk for major events linked to depression or anxiety could be explained by the accelerated emergence of cardiovascular risk factors.
- Participants with a higher genetic predisposition to stress (a polygenic risk score for neuroticism) tended to develop their first cardiovascular risk factor about 1.5 years earlier than those without the genetic marker.
The authors propose that psychological distress may alter brain function in ways that trigger inflammation, metabolic changes and fat deposition—processes that promote cardiovascular risk. The study underscores the need for clinicians to consider more frequent monitoring of blood pressure, cholesterol and blood glucose in patients with depression or anxiety. While the analysis adjusted for use of antidepressant or anxiolytic medications and found little change in the results, the researchers note the study’s observational design and potential diagnostic misclassification as limitations.
Associations of cumulative perceived stress with cardiovascular risk and outcomes: Dallas Heart Study (MDP100)
A second study created a “cumulative stress score” by combining measures of everyday stress, psychosocial stress (threats to psychological or social functioning), financial strain and neighborhood-related stress in participants from the Dallas Heart Study who had no baseline cardiovascular disease. Researchers then evaluated the score’s relationship to cardiovascular risk factors and long-term outcomes.
Major results showed that higher cumulative stress was associated with:
- A 22% increased risk of atherosclerosis (plaque buildup in the arteries).
- A 20% increased risk of overall cardiovascular disease, including coronary artery disease and heart failure.
- Greater prevalence among women, adults aged 18–45, people with lower income and education, and participants who identified as Black or Hispanic.
Higher cumulative stress also correlated with racial or ethnic discrimination, lack of health insurance and lifestyle risks such as smoking, physical inactivity and overweight status. The findings suggest that a multidimensional measure of stress captures cardiovascular risk more effectively than single-item assessments. Chronic stress can raise stress hormones like cortisol, altering blood sugar, inflammation and other biological pathways that harm the heart over time.
The authors recommend that clinicians routinely ask patients about stress burden and consider screening for high stress to help reduce downstream cardiovascular risk. Limitations include the novel cumulative score’s need for further validation and the possibility of unmeasured confounders.
About this mental health and cardiovascular disease research
Author: Bridgette McNeill
Source: American Heart Association
Contact: Bridgette McNeill – American Heart Association
Image: The image is credited to Neuroscience News
Original Research: Findings were presented at the American Heart Association Scientific Sessions 2023.