People with persistent mental distress are at increased risk of dying from coronary heart disease, a study published last night finds.
Although previous research has linked anxiety and depression to an increased risk of heart attack and stroke, most of the studies have been based on a single assessment – soon after the patient suffered the event.
However, a New Zealand-based observational study has found a “substantial” increase in risk among people who were tracked for an average of 12 years.
Writing in Heart, the research team, led by Auckland City Hospital, described examining the association between occasional or persistent mental distress and the risk of death in 950 people with stable coronary heart disease who were between 31 and 74 years old.
All were part of the Long Term Intervention with Pravastatin in Ischaemic Disease Trial and had had a heart attack or been admitted to hospital for unstable angina in the preceding three to 36 months.
They filled in a validated general health questionnaire (GHQ30) at six months, and then at one, two and four years after the health event to establish their levels of mental distress, which were graded according to severity.
The participants’ health and survival were tracked for an average of 12 years and during the monitoring period, 398 people died from all causes and 199 died from cardiovascular disease.
The questionnaire responses showed that 62% (587) said they had not been distressed at any of the assessments, while 27% had reported experiencing occasional distress of any severity. A further 8% said they had experienced persistent mild distress, while 3.7% (35) people said they had persistent moderate distress.
It was people in this last group that were nearly four times as likely to have died of cardiovascular disease and nearly three times as likely to have died from any cause compared to those who said they had not been distressed at any of the assessments.
Although it was an observational study, the research team say the increase in risk of death was “substantial”.
“These findings suggest that in patients with stable [coronary heart disease], long term mortality risk is related to the cumulative burden of psychological distress,” they add.
Stewart R, Colquhoun D, Marschner S et al. Persistent psychological distress and mortality in patients with stable coronary artery disease. Heart 27 June 2017; doi 10.1136/heartjnl-2016-311097 [abstract]
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