Young Below 40? The real reason you may be at higher risk of heart attack or stroke than psychological problems such as insomnia, depression, anxiety, and eating disorders.
A recent study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC), reveals that young adults in their 20s and 30s with mental disorders have an increased likelihood of experiencing a heart attack or stroke, up to three times higher than those without such conditions.
The study included over 6.5 million individuals.
The study also revealed that one in every eight participants between the ages of 20 to 39 had some form of mental illness, including depression, anxiety, and insomnia.
“Psychological problems were common in young adults and had strong links with cardiovascular health,” points out study author Professor Eue-Keun Choi.
The results show “that these individuals should receive regular health check-ups and medication if appropriate to prevent myocardial infarction and stroke. While lifestyle behaviours 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.”
The new study explored the link between mental disorders in adults aged 20-39 years and the risk of developing myocardial infarction (heart attack) and ischemic stroke. Conducted using the Korean National Health Insurance Service (NHIS) database, which covers the entire population of the country, the study analyzed a sample of 6,557,727 individuals aged 20 to 39 years. The participants had undergone health examinations between 2009 and 2012 and had no history of myocardial infarction or stroke. More than half of the participants (58%) were over 30 years old, and the average age was 31 years. The study aimed to investigate the potential link between mental disorders and cardiovascular diseases in young adults.
Out of the total 6,534,223 participants, a significant number of 856,927 (13.1%) individuals were found to have been affected by at least one mental disorder. Of those affected by mental health issues, anxiety was found to be the most common disorder affecting almost half of the individuals (47.9%). The second most prevalent condition was depression, which was found in more than one in five participants (21.2%), while insomnia was identified in 20% of the cases. Somatoform disorder was found in 27.9% of the participants affected by mental health issues, with substance use disorder identified in 2.7%, bipolar disorder in 1.3%, schizophrenia, and eating disorder in 0.9% each, and personality disorder and post-traumatic stress disorder (PTSD) in 0.7% and 0.4% of the participants, respectively.
The participants of the study were monitored until December 2018 to determine if they developed new cases of myocardial infarction or stroke. Over a median period of 7.6 years, a total of 16,133 myocardial infarctions and 10,509 strokes were recorded. After taking into account factors such as age, sex, high blood pressure, diabetes, high cholesterol, metabolic syndrome, chronic kidney disease, smoking, alcohol, physical activity, and income, the authors analyzed the link between mental disorders and cardiovascular outcomes.
Participants who had any form of mental disorder showed a 58% increased likelihood of experiencing a myocardial infarction and a 42% greater risk of stroke compared to those without any mental disorder. All mental disorders studied exhibited an elevated risk of myocardial infarction, with the magnitude ranging from 1.49- to 3.13-fold. PTSD had the highest risk of myocardial infarction at 3.13 times higher compared to participants with no mental disorder, followed by schizophrenia at 2.61 times higher, substance use disorder at 2.47 times higher, bipolar disorder at 2.40 times higher, personality disorder at 2.29 times higher, eating disorders at 1.97 times higher, insomnia at 1.73 times higher, depression at 1.72 times higher, anxiety at 1.53 times higher, and somatoform disorder at 1.49 times higher, when compared to those without any mental disorder.
According to the study, individuals with mental health issues have a higher risk of stroke, except for those with PTSD and eating disorders. The hazard ratios for these conditions ranged from 1.25 to 3.06, with the highest risk associated with personality disorder at 3.06, followed by schizophrenia at 2.95, bipolar disorder at 2.64, substance use disorder at 2.44, depression at 1.60, insomnia at 1.45, anxiety at 1.38, and somatoform disorder at 1.25.
According to the authors’ analysis, there were differences in the associations observed between age and sex. Myocardial infarction risks were higher for participants in their 20s who had depression, anxiety, schizophrenia, or personality disorders, compared to those in their 30s. Moreover, women were found to have a higher risk of heart attack and stroke when experiencing depression and insomnia than men.
“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,” comments Study author Dr. Chan Soon Park.
The results of the study signal “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.”
Source: 10.1093/eurjpc/zwad102
Image Credit: Getty