Attaining and sustaining good mental health is just as vital as other factors, such as exercise and diet, in the prevention of cardiovascular disease, especially for women over the age of 45, according to a study by Emory University sociologist Corey Keyes published this month in the journal Aging and Mental Health.

Using national survey data, Keyes' study examined the prevalence of mental health issues among people with cardiovascular disease, the leading cause of death in the United States. In investigating linkages between the two, Keyes used a measure of mental health as a "complete state" that looked beyond episodes of mental illness to also incorporate the subjective well-being of people, and how well they are functioning and flourishing in life.

The study found that cardiovascular disease was lowest in adults who were the most mentally healthy, and higher among adults with major depressive episodes, minor depression and moderate mental health. The relationship between cardiovascular disease and mental health was the same for age and sex, except for females between the ages of 45 and 74, where mental health issues under his "complete state" measure were much more prevalent.

Previous research has found major depression and stress to be contributing factors for, and a consequence of, cardiovascular disease, Keyes says. Although good mental health traditionally has meant the absence of mental illnesses like depression, health care professionals, in treating patients with cardiovascular disease, "should view and evaluate mental health as more than merely the absence of psychopathology, and look at the full picture of how their patients are coping and functioning in life," he says

Overall, only 17 percent fit the criteria for full mental health in the study. As a result, estimates of cardiovascular disease risk among adults with lower levels of positive mental health are likely to be inaccurate and possibly underestimated, he says.

"We seriously underestimate the connection between mental health and cardiovascular disease, especially for post-menopausal women. We are not doing as well in treating mental health on par with other risk factors," says Keyes, an associate professor of sociology who conducted the study in conjunction with Emory's Rollins School of Public Health.

Keyes' study used data from a representative sample of American adults between the ages of 25 and 74 collected in 1995 from the MacArthur Foundation's "Midlife in the United States" survey. About 12 percent of adults reported some form of cardiovascular diseases. Independent of mental health status, risk for any cardiovascular disease increased with age and as education decreased, and the risk was higher among males, married adults and unemployed adults.

Keyes is lead editor of "Flourishing: Positive Psychology and the Life Well-Lived," published in 2002 by the American Psychological Association, and is co-editor of "Well-Being: Positive Development Throughout the Life Course," published in 2003 by Lawrence Erlbaum Associates Inc.

Emory University is known for its demanding academics, outstanding undergraduate college of arts and sciences, highly ranked professional schools and state-of-the-art research facilities. For more than a decade Emory has been named one of the country's top 25 national universities by U.S. News & World Report. In addition to its nine schools, the university encompasses The Carter Center, Yerkes National Primate Research Center and Emory Healthcare, a comprehensive metropolitan health care system.

Contact: Beverly Cox Clark
Emory University Health Sciences Center