Mental illness in young adults tied to heart attack, stroke risk
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Key takeaways:
- Researchers observed excessive risk for MI and stroke in young adults with mental illnesses.
- Patients with mental illness did not have worse metabolic profiles.
Young adults with any mental disorder are at 58% greater risk for MI and 42% greater risk for stroke compared with those without a mental illness, data from a population-based study show.
In an analysis of Korean National Health Insurance Service (NHIS) data, researchers also found that depression and insomnia were linked to greater risks for MI and stroke in women than men.
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“Psychological problems were common in young adults and had strong links with cardiovascular health,” Eue-Keun Choi, MD, professor in the department of internal medicine at Seoul National University College of Medicine, South Korea, said in a press release. “The findings indicate that these individuals should receive regular health checkups and medication if appropriate to prevent myocardial infarction and stroke. While lifestyle behaviors did not explain the excess cardiovascular risk, this does not mean that healthier habits would not improve prognosis. Lifestyle modification should therefore be recommended to young adults with mental disorders to boost heart health.”
Choi and colleagues analyzed data from 6,577,727 adults aged 20 to 39 years who underwent nationwide health examinations between 2009 and 2012 and had no baseline CVD. Researchers stratified patients according to mental disorders including depressive disorder, bipolar disorder, schizophrenia, insomnia, anxiety disorder, PTSD, personality disorder, somatoform disorder, disordered eating and substance use disorder. Researchers followed the cohort for incidence of MI or stroke through December 2018.
The findings were published in the European Journal of Preventive Cardiology.
Within the cohort, 13.1% of young adults had at least one mental health disorder. Among them, 47.9% had anxiety; 21.2% had depression and 20% had insomnia. Young adults with and without mental illness had similar prevalence of hypertension, diabetes, dyslipidemia, metabolic syndrome and chronic kidney disease. Lifestyle behaviors, including smoking and heavy alcohol consumption, were also similar between groups.
During a mean follow-up of 7.6 years, there were 16,133 cases of MI and 10,509 cases of stroke.
Patients with mental disorders showed significantly increased risks for MI (HR = 1.58; 95% CI, 1.51-1.64) and stroke (HR = 1.42; 95%, CI, 1.35-1.5) after adjustment for covariates.
Researchers found that the overall diagnosis and each mental disorder were independently associated with increased CV endpoints.
Young patients with mental disorders showed increased risks for MI with depressive disorders (HR = 1.72; 95% CI, 1.59-1.83), bipolar disorder (HR = 2.4; 95% CI, 1.86-3.1), schizophrenia (HR = 2.61; 95% CI, 1.98-3.44), insomnia (HR = 1.73; 95% CI, 1.61-1.87), anxiety disorder (HR = 1.53; 95% CI, 1.45-1.62), PTSD (HR = 3.13; 95% CI, 2.02-4.85), personality disorder (HR = 2.29; 95% CI, 1.6-3.27), somatoform disorder (HR = 1.49; 95% CI, 1.39-1.6), disordered eating (HR = 1.97; 95% CI, 1.35-2.88) and substance use disorder (HR = 2.47; 95% CI, 2.13-2.87).
Similarly, researchers observed higher stroke risk in young patients with depressive disorder (HR = 1.6; 95% CI, 1.45-1.76), bipolar disorder (HR = 2.64; 95% CI, 1.96-3.55), schizophrenia (HR = 2.95; 95% CI, 2.13-4.07), insomnia (HR = 1.45; 95% CI, 1.32-1.61), anxiety disorder (HR = 1.38; 95% CI, 1.29-1.48), personality disorder (HR = 3.06; 95% CI, 2.08-4.5), somatoform disorder (HR = 1.25; 95% CI, 1.14-1.37) and substance use disorder (HR = 2.44; 95% CI, 2.03-2.93), but not in those with PTSD or disordered eating.
“Patients with mental health problems are known to have a shorter life expectancy than the general population, with the majority of deaths due to physical illnesses,” Chan Soon Park, MD, of Seoul National University Hospital, South Korea, said in the release. “Our study shows that substantial numbers of young adults have at least one mental health problem, which may predispose them to heart attack and stroke. Future research should examine the cardiovascular benefits of managing psychological problems and monitoring heart health in this vulnerable group.”
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