Depression and anxiety linked to lower levels of heart health in young adults

Young adults with depression or anxiety may be more likely to have lower levels of cardiovascular health, new research shows.

Adults ages 18-34 who have moderate to severe anxiety or depression were more likely to smoke and have excess weight, and were less likely to get adequate exercise, according to the findings presented last week at the American Heart Association's virtual Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference.

This is the latest contribution to a growing body of research showing how depression and anxiety impact heart health.

For example, a 2011 study in Psychiatry Research found people experiencing post-traumatic stress had a higher likelihood of poor heart health, while a 2018 study in the journal Psychosomatic Medicine suggested prolonged mental stress can increase heart disease risk.

Federal statistics show about 8% of U.S. adults had depression in 2019, according to the Substance Abuse and Mental Health Services Administration. During the COVID-19 pandemic, the percentage of U.S. adults who experienced depression or anxiety jumped from 36.4% to 41.5%, with the highest spike among people ages 18-29, according to data from the Centers for Disease Control and Prevention.

Previous research has focused mainly on older adults who are more likely to have risk factors for cardiovascular disease. But "mood disorders like depression and anxiety commonly emerge in younger adults, so I was interested in seeing whether they're associated with cardiovascular health in this age group," said lead researcher Sierra Patterson, a clinical research coordinator in the department of pediatrics at Emory University School of Medicine in Atlanta.

She and colleagues analyzed self-reported data from 882 young adults. They classified the participants as having poor, intermediate or ideal levels of Life's Simple 7, a term coined by the AHA for a collection of lifestyle targets shown to help achieve ideal heart and brain health. The seven metrics are blood pressure, cholesterol, blood sugar, physical activity, diet, weight and not smoking.

The finding showed 134 participants – about 15% – had moderate to severe anxiety. They were less likely to have optimal levels of physical activity, smoking and weight, and a cardiovascular health score 0.91 points lower, compared to those without the condition. Similarly, 15% of participants had moderate to severe depression and scored worse on the same metrics, as well as cholesterol and blood pressure.

"These findings give (perspective on) a different demographic and suggest that we should start looking at both depression/anxiety and cardiovascular health in younger adults," Patterson said. The findings are considered preliminary until published in a peer-reviewed journal.

An AHA scientific statement published this year in Circulation summarized the recent evidence of biological, behavioral and psychological pathways that link mental health to heart disease. The statement suggested that because of the clear link emerging between psychological health and heart health, doctors should assess the mental well-being of heart patients as part of their routine care.

Dr. Nieca Goldberg, medical director of New York University's Women's Heart Program, said the findings underscore the importance of monitoring both mental health and heart health in this younger age group.

"People who tend to smoke" – one of the biggest risk factors for heart disease – "may be smoking to counterbalance their anxiety or depression," said Goldberg, a clinical associate professor at NYU's Grossman School of Medicine who was not involved in the new research. But, as of now, she said no study has shown that interventions to treat anxiety or depression have an effect on lowering risk factors for cardiovascular conditions.

That doesn't mean people can't take steps to elevate their mental and cardiovascular well-being. Goldberg said aerobic exercise, even a low-impact activity like walking the dog, improves mood and stamina.

Patterson advised getting better sleep, maintaining a healthy weight and eating a balanced diet. "I think it comes down to doing things that make you feel good as a person that are also contributing to your cardiovascular health."

The study suggests physicians should continue to routinely screen their younger patients for depression and anxiety – and to look out for cardiovascular issues at the same time. Patterson also suggests the reverse. If a young adult seems at risk for heart disease, health professionals should ask about their mental well-being.

"It's important to target people before they get to an age where it's harder for them to modify their behaviors," she said. "Being able to catch these risk factors earlier will be beneficial overall."

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