Experts say certain mental health therapies can help reduce the risk of cardiovascular disease. Hayden Williams/Stocksy United Researchers say people with severe mental illness have a higher risk of developing and dying from cardiovascular disease. They note that people with mental illnesses such as bipolar disorder and schizophrenia tend to have higher rates of smoking and other lifestyle factors that can contribute to poorer heart health. Experts say mental health professionals and cardiologists should work together on this issue. People with severe mental illness are more likely to develop and die from cardiovascular disease (CVD) than those without mental health issues, according to a review of more than 100 studies. The researchers reviewed 108 previous studies with more than 30 million participants in high-income countries. The participants were diagnosed with a mental illness between the ages of 16 and 65. The study authors say that severe mental illness, including bipolar disorder, schizophrenia, and major depressive disorder, is associated with cardiovascular disease. They said this association has increased since the 1970s. They also report that “people with schizophrenia are at greater risk than those with bipolar disorder, but the disparity exists across all types of severe mental illness and both cerebrovascular and cardiac mortality.” The researchers noted that there may be lifestyle and other factors at play here. “The increased relative risk of CVD diagnosis in more recent decades may result from disparity in smoking prevalence between people with [severe mental illness] and the general population or increased use of antipsychotics. The changes since the 1990s approximately coincide with the release of newer, second-generation antipsychotics known to have worse metabolic effects,” the authors say.
According to a , people with mental illness have certain risk factors, such as high rates of smoking and antipsychotics, that can contribute to obesity, insulin resistance, diabetes, heart attacks, atrial fibrillation, stroke, and death. Cardiovascular diseases are the most common cause of death in people with severe mental illness, especially schizophrenia. Researchers in the new study reported that people with schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, and post-traumatic stress disorder have higher rates of cardiovascular disease. “Based on the observational nature of the current study, we can only describe an association between cardiovascular disease and severe mental illness, not a cause and effect relationship,” Dr. Michael Chan, a cardiologist in Southern California, told Healthline. “However, many of the risk factors that lead to heart disease can also contribute to mental illness, such as smoking, drug use, poor dietary habits, and a sedentary lifestyle.” It is also possible there are other connections besides smoking and medications. The researchers reported there seem to be common biological, behavioral, psychosocial, and genetic factors present in both mental illness and cardio-metabolic diseases. There might also be genetic correlations between cardiac diseases and mental health disorders. The researchers found that the relationship between the two conditions is further complicated because mental illness is common in people with coronary heart disease. Depression is about four times more common in people with coronary heart disease than in the general population, they reported.
What can cardiologists do? With the strong connections between cardiovascular disease and mental illness, it might be helpful for people with mental illness to be referred to a cardiologist, experts say, especially those who gain weight while taking their medications. “Primary care physicians are more than capable to assist patients who develop weight gain, whether from unhealthy living or from medications,” said Chan. “If the weight gain cannot be controlled, then it may be prudent to consult with the patient’s primary mental health specialist about alternative treatment options that may not have the same weight gain side effect.” However, Dr. Jim Liu, a cardiologist at the Ohio State University Wexner Medical Center, believes “it would be useful for these patients to be evaluated by a cardiologist. Weight gain can also be associated with developing other cardiovascular risk factors such as high blood pressure, high cholesterol, and diabetes.” Treatment for heart disease can also help decrease mental illness, he said. “The same lifestyle measures also help with mental health. For example, a heart-healthy diet consisting of fruits, vegetables, healthy fats, and whole grains has been shown to help with anxiety and depression,” Liu told Healthline. “Also, regular exercise is a key component to maintaining cardiovascular health, but it also helps improve emotional well-being and reduces rates of mental illness.”