People with mental health disorders may be at much higher risk of heart disease or stroke than the general population. This is according to a new study recently presented at this year's Canadian Cardiovascular Congress in Vancouver, Canada.
According to the National Alliance on Mental Illness, around 1 in 4 adults in the US experience some form of mental illness in any given year. Approximately 1 in 17 adults live with a severe mental illness, such as major depression, schizophrenia or bipolar disorder.
Past studies have associated mental health disorders with increased risk of cardiovascular problems. Last year, for example, Medical News Today reported on a study linking bipolar, schizophrenia, depression, neurotic disorders and other mental illnesses to a higher risk of coronary heart disease.
For this latest study, the research team - led by Dr. Katie Goldie, a postdoctoral fellow at the Centre for Addiction and Mental Health in Toronto, Canada - set out to gain a better understanding of the link between mental illness and cardiovascular risk.
They analyzed data from the Canadian Community Health Survey, involving patients with schizophrenia, bipolar, major depression and anxiety disorders. MNT were unable to identify how many people were included in the study at the time of publication.
The researchers assessed patients' use of medication for their mental health disorders. The drugs used included antipsychotic medications, antidepressants, psychoactive medication (benzodiazepine) and mood-stabilizing drugs. They also looked at the incidence of cardiovascular events among participants.
They found that patients who had a mental illness at any point in their life were twice as likely to have had a stroke or experienced heart disease than the general population, while patients who had not experienced heart disease or stroke had a higher long-term risk of cardiovascular disease.
Furthermore, patients who used psychiatric medications for their mental illness were twice as likely to have heart disease and three times as likely to have had a stroke than those who did not use such medications.
"This population is at high risk," says Dr. Goldie, "and it's even greater for people with multiple mental health issues."
What increases the risk of cardiovascular problems among mental health patients?
The team identified a number of factors that may explain why people with mental health disorders are at higher risk of cardiovascular problems.
- Around 50% of all chronic mental health disorders begin by the age of 14, while 75% occur before the age of 24
- Around 60% of adults and 50% of youths with a mental illness received no mental health services in the past year
- Serious mental illness costs the US around $193.2 billion in lost earnings every year.
Firstly, Dr. Goldie notes that people with mental illness often adopt behaviors that increase their risk of such problems, including a poor diet, smoking, drinking alcohol and lack of exercise. When it comes to smoking, for example, she points out that 40-90% of Canadians with a mental health disorder smoke tobacco, compared with 20% of the general population.
Dr. Goldie says that psychiatric medications account for a lot of the elevated cardiovascular risk among patients with mental illness. She explains that the drugs can trigger weight gain, as well as interfere with the body's breakdown of fats and sugars. This may lead to obesity, diabetes and high cholesterol.
Furthermore, Dr. Goldie says that individuals with mental health disorders often have problems talking about their illness, or the symptoms of their illness may stop them from seeking care. "A separation between primary and mental health services can also challenge these patients' care," she adds. "We need improved integration and collaboration."
Dr. Goldie says the stigma that remains attached to mental health disorders may even affect the care given by health professionals. She points out that patients with these disorders are less likely to receive treatments that reduce the risk of adverse cardiovascular outcomes or undergo coronary procedures, such as bypass surgery.
Mental health patients require closer attention from health care providers
Based on their findings, the research team believes health care professionals should be more attentive when it comes to treating patients with mental health disorders.
They believe these patients should undergo routine cardiovascular health assessments before and after receiving psychiatric medications, and be offered interventions that help reduce the risk of cardiovascular health issues.
Dr. Brian Baker, of the Heart and Stroke Foundation of Canada - a co-host of the Canadian Cardiovascular Congress alongside the Canadian Cardiovascular Society - adds:
"The prevention strategies are the same for people with mental health issues. That means eating a healthy diet, being physically active, being smoke-free, managing stress and limiting alcohol consumption. Making positive health behavior changes is important to our physical health and to mental health, too."
He adds that ongoing follow-up with health care professionals is "essential" for mental health patients. Furthermore, he notes that although certain psychiatric drugs may increase the risk of cardiovascular health issues, the benefits often outweigh the risks, therefore patients should not stop taking their prescribed medications.
MNT recently reported on a study suggesting that the effects of mental stress on the heart differ between men and women.