A mental illness in your 20s and 30s could mean a greater chance of heart attack and stroke

By Madeline Holcombe, CNN

Adults in their 20s and 30s with mental disorders have a higher chance of having a heart attack or stroke, according to a new study.

The study published Monday in the European Journal of Preventive Cardiology looked at the health data of more than 6.5 million people through the Korean National Health Insurance Service database.

The people included in the new study ranged in age from 20 to 39 and underwent health examinations between 2009 and 2012. Their health was monitored until December 2018 for new onset heart attacks and stroke.

About 13% of participants had some type of mental disorder — which included insomnia, anxiety, depression, somatoform disorder, post-traumatic stress disorder, substance use disorder, eating disorders, bipolar disorder, schizophrenia or a personality disorder, according to the study.

Those people younger than 40 with a mental disorder were 58% more likely to have a heart attack and 42% more likely to have a stroke than those with no disorder, the study found.

“We have known for some time that mental health and physical health are linked, but what I find surprising about these findings is that these links were observable at such a young age,” said Dr. Katherine Ehrlich, an associate professor of behavioral and brain sciences at the University of Georgia. Ehrlich was not involved in the research.

Coronary arterial disease and heart attacks are rare before the age of 40, so a study as large as this one was needed to see the relationship between mental health and such an unusual occurrence in young people, she said.

Mental health and lifestyle

Ehrlich said she would like to know more about the physical activity and diets of the people involved to understand better if those factors have an influence on the relationship between mental health conditions and heart attack and stroke.

“For example, if you are chronically depressed, you may struggle to maintain a healthy diet and get adequate physical activity, which might in turn increase your risk for cardiac events over time,” she said.

But the increased risk could not be attributed to lifestyle differences alone, as the authors controlled for factors including age, sex, high blood pressure, diabetes, high cholesterol, metabolic syndrome, chronic kidney disease, smoking, alcohol, physical activity and income, the study said.

That doesn’t mean lifestyle should be ignored, however, said study author Dr. Eue-Keun Choi, a professor of internal medicine at Seoul National University College of Medicine in South Korea.

“While lifestyle behaviours did not explain the excess cardiovascular risk, this does not mean that healthier habits would not improve prognosis,” Choi said in a statement. “Lifestyle modification should therefore be recommended to young adults with mental disorders to boost heart health.”

Changes and checkups

One in eight people between ages 20 and 39 studied had some sort of mental illness, meaning a substantial number of people could be predisposed to heart attack and stroke, study author Dr. Chan Soon Park, a researcher at Seoul National University Hospital in South Korea said in a statement.

That could point to a greater need for managing psychological conditions and monitoring heart health in those at risk, Park added.

“If we can reduce the number of people living with chronic mental illness, we may find secondary benefits in future years regarding the number of people managing cardiac-related conditions,” Ehrlich said.

It is important to note that the findings do not show that mental illness causes heart attacks or stroke, she added. But the research does indicate a risk factor to watch out for.

There may be benefit in preventive measures to minimize risks, Ehrlich said, which can include maintaining a healthy diet and incorporating physical activity.

Choi recommends that people with mental health conditions receive regular checkups as well.

These findings may also emphasize the importance of addressing loneliness, she added.

“Many individuals with mental illness suffer from social isolation and loneliness, and for years researchers have been sounding the alarm that loneliness is detrimental for physical health,” Ehrlich said.

“Efforts to improve social connectedness among young people may be critical to addressing the rising rates of cardiometabolic conditions in adulthood,” she added.

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