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How mental health affects heart health

Heart diseases illustration: Open heart surgery. Credit:|&mediapopup=40119386On the face of it, mental health issues and heart health may not seem to have an obvious connection. Yet researchers have identified a link between the two, drawing a connection between mental health disorders such as anxiety and depression and coronary artery disease (CAD).

“A personality with anger, aggression, hostility and a feeling of urgency at all times may be associated with CAD,” said Dr C Radhakanth, who heads the psychiatry department at the NRI Institute of Medical Sciences. “States of fear, excitement and acute anger reduce blood flow through blood vessels or arteries that provoke coronary spasm and cause ‘myocardial ischemia’ or result in death in some cases where the personality is so predisposed.”

Mental health disorders affect approximately ten percent of Indians, with depression and anxiety disorders alone affecting 56 million and 38 million people respectively. Heart disease, meanwhile, is one of the country’s dominant and ever-growing health concerns, having risen by fifty percent in the past 25 years. Understanding risk factors for heart disease is vital in addressing it, with the prospect of a mental health connection undoubtedly worthy of investigation. 

“Some factors known to contribute to a higher risk of heart disease (for example, an unhealthy diet, lack of exercise, and smoking) are also common in people with mental health issues,” reads a Harvard Heart Letter article published last year. Yet even in the absence of these risk factors, there is the potential for a heightened risk of heart disease in those with mental health conditions. Based on a study of 21,000 people with no previous history of heart disease, after four years “people who had reported high or very high levels of depression and anxiety were more likely to have had a heart attack or stroke than people without those symptoms.” 

The link has not been definitively established. The Harvard Heart Letter piece emphasises “these findings do not necessarily mean that psychological distress causes heart disease. Instead, both may arise (at least in part) from the same underlying mechanisms.” Further investigation is needed into the link and what contributes to it. But experts seem to concur that awareness is needed. 

“The head-heart connection should be on everyone’s radar,” opines Dr Barry Jacobs, Director of Behavioral Sciences at the US-based Crozer-Keystone Family Medicine Residency Program. “It’s not just being unhappy. It’s having biochemical changes that predispose people to have other health problems, including heart problems.” 

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