Younger adults who have mental health disorders are more likely to suffer a heart attack or stroke, according to a landmark new study.
The study, which involved 6.5 million people and was published in the journal of the European Society of Cardiology, found that lifestyle behaviours did not explain the increased risk, but mental illness was a clear factor.
For adults aged in the 20s and 30s, having a mental disorder could have up to a three-fold increase of risk of a heart attack or stroke, the study found.
It used the Korean National Health Insurance Service’s database, which covers the entire population of South Korea.
More than 6.5 million people underwent health exams when they were aged between 20 and 39 years old, between the years 2009 and 2021. Nobody with a history of heart attack or stroke was included in the study.
The study looked at the association between mental health disorders and the risk of developing myocardial infarction (heart attack) and ischaemic stroke, the most common type of stroke which involves a blood clot in the brain.
Around 13 per cent of the study participants had at least one mental disorder, and of those nearly half had anxiety.
More than one in five had depression, and one in five had insomnia. Others had a form of somatoform disorder, substance use disorder, bipolar disorder, schizophrenia, eating disorders, personality disorders, and post-traumatic stress disorder (PTSD).
Those with any mental disorder had a 58 per cent higher likelihood of myocardial infarction and 42 per cent greater risk of stroke compared to those with no mental health issue.
“Psychological problems were common in young adults and had strong links with cardiovascular health,” said study author Professor Eue-Keun Choi of Seoul National University College of Medicine.
“The findings indicate 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”.
Up to three times more risk
There was a median follow-up period of 7.6 years, in which time there were 16,133 heart attacks and 10,509 strokes.
The authors analysed any association with other factors that could increase risk, including age, sex, high blood pressure, diabetes, cholesterol, smoking, drinking alcohol, income levels and physical activity. These other factors did not show an association with higher risk, the authors said.
For people with PTSD, the risk of heart attack was more than three times higher than for those without any condition.
It was 2.61 times higher for those with schizophrenia, 2.47 for those with substance use disorder, and 2.4 times higher for those with bipolar disorder.
The risk of stroke was elevated for all mental health issues except PTSD and eating disorders, with both personality disorders and schizophrenia accounting for around a three fold increase in risk.
Depression and insomnia were linked with greater risks of heart attack and stroke in women 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, said study author Dr Chan Soon Park of Seoul National University Hospital.
“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”.