Mental Health Disorders:  
2x Risk for Heart Disease or Stroke

We’ve all known that depression can be a debilitating and lifelong affliction. But the consequences of having depression have now been increasingly shown to affect other aspects of the lives of those who live with it to a staggering new level. Past studies have associated mental health disorders with increased risk of cardiovascular problems and a higher risk of coronary artery disease. 

According to a study presented recently at the Canadian Cardiovascular Congress, Dr. Katie Goldie, lead author of the study and a postdoctoral fellow at the Centre for Addiction and Mental Health in Toronto, has uncovered that people facing mental health challenges are significantly more likely to have heart disease or stroke.

The Beginning Of The Study

Dr. Goldie and her team used data from the Canadian Community Health Survey involving patients with schizophrenia, bipolar, major depression and anxiety disorders, to see if they could uncover any further understanding of the link between mental illness and cardiovascular risk. Investigators assessed patients' use of medication for their mental health disorders, which included antipsychotic medications, psychoactive medication (benzodiazepine), mood-stabilizing drugs and antidepressants. They also looked at the incidence of cardiovascular events among participants.

The Results

The study revealed three distinct and alarming facts:

1.  People who have had a mental health disorder at any point in their life were twice as likely to have had heart disease or have experienced a stroke.

2.  Those who haven't developed heart disease or had a stroke are more likely to be at a high long-term risk of developing cardiovascular disease, when compared to the general population.

3.  People who used psychiatric medications were twice as likely to have heart disease and three times as likely to have had a stroke compared to those not taking these medications.

So why would an illness like depression cause such an increase in cardiovascular disease? The research team laid out a number of reasons they believed placed these individuals at higher risk.  Dr. Goldie noted that people with mental illness often adopt behaviors that increase their risk of such problems, including a poor diet, smoking, drinking alcohol and lack of exercise. As an example, she cited the fact that only 20% of Canadians are smokers, but 40-90% of the population who have a diagnosed mental health disorder smoke tobacco. This is an enormous disparity.  Dr. Goldie further noted that psychiatric medications account for much of the increased cardiovascular risk among patients with mental illness. The drugs taken by these patients are often associated with weight gain, and are known to interfere with the body's breakdown of fats and sugars. This could lead to obesity, high cholesterol and/or diabetes in these patients.

Furthermore, Dr. Goldie says that individuals with mental health disorders often have problems talking about their illness, or the symptoms of their illness may stop them from seeking care. "A separation between primary and mental health services can also challenge these patients' care," she adds. "We need improved integration and collaboration." Mental health problems can often become debilitating. Patients commonly do not seek out medical help simply because they are unable to do so.

In addition, there is still a stigma that remains attached to mental health disorders, which may even affect the level of care given by health professionals. Goldie points out that patients with these disorders are less likely to receive treatments that reduce the risk of adverse cardiovascular outcomes or undergo coronary procedures, such as bypass surgery.

Despite these drawbacks, a growing body of evidence has shown a strong link between both mental and physical health. It is essential that people receive treatment for their mental disorders, as well as address any physical concerns with medical professionals regarding their overall health and wellness.

Health care professionals should also be more proactive when it comes to treating patients with mental health disorders. These patients should undergo routine cardiovascular health assessments before and while receiving any prescribed psychiatric medications. They should also be given instructions as to how they can help reduce their risk of cardiovascular health issues.

It is essential for mental health patients to receive ongoing medical care in addition to any psychiatric care they may be receiving. Often times these at-risk patients routinely see psychiatrists who prescribe medication and do not follow up with lab work, or address the physical implications of the drugs.   That is not to say the drugs should be discontinued, only more closely monitored as the benefits often outweigh the risks.  Continual collaboration and routine follow-ups with their primary physician in addition to their mental health care provider is essential to the monitoring of their overall health. 

Conclusion:  A strong link exists between mental health disorders and cardiovascular/stroke risk.

- Laura Wells

Heart and Stroke Foundation of Canada. (2014, October 27). People with mental health disorders twice as likely to have heart disease or stroke. ScienceDaily. Retrieved December 1, 2014 from www.sciencedaily.com/releases/2014/10/141027085432.htm

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