Mental Health and the Heart

We have long known that there are strong connections between heart health and mental health. And the connection goes both ways.

Depression commonly develops in patients after they have had a heart attack. In fact, major depression affects as many as 15-20% of patients in the hospital with a heart attack, and milder forms of depression likely occur in many more individuals. Women are most likely to be affected, especially younger women. Having depression after a heart attack makes recovery harder. People with depression may find it harder to take medications regularly, follow up with their care providers, and take care of themselves. Depression clearly increases the risk of being re-hospitalized.

We also know that people with depression develop heart disease at higher rates than people without depression.  A study released this week in the Journal of the American College of Cardiology gives us new information about the links between another important mental health issue, PTSD (post-traumatic stress disorder) and heart disease. A group of researchers at Emory University in Atlanta followed 562 twins from the Vietnam Era Twin Registry. Of the 177 individuals who had PTSD, nearly 1 in 4 developed heart disease. Of the other 425 without PTSD, less than 1 in 10 developed heart disease. The study also compared ‘twin sets,’ particularly those where one twin developed PTSD and the other did not. In such cases, the risk of having heart disease was nearly double the twin with PTSD.

Post-traumatic stress disorder affects as many as 7 million adults in the US alone. It can develop after someone has experienced a traumatic event. In fact, PTSD can even develop after having a major health issue, like a stroke.  People with PTSD continue to feel stressed and afraid even when they are no longer in danger or in the stressful situation. You can read more information about the symptoms and treatment of PTSD here.

As a medical community, we need to be more aware of the risks that mental health conditions pose for our patients. Depression and other mental health concerns affect recovery and treatment of heart disease. But this research also adds to the information that mental health issues may have a direct effect on the heart.

Much work is yet to be done on improving our care of patients with mental health issues. We need better ways to help identify patients who are at risk and we need better methods to treat them. Doing so will no doubt be good for both the mind and the heart.

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