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Depression and Poor Mental Health Days Independently Associated With Premature Cardiovascular Disease
Depression and poor mental health are linked with premature cardiovascular disease (CVD) and suboptimal cardiovascular health (CVH) in young adults, according to a new cross-sectional analysis published in the Journal of the American Heart Association.
“Although this association is likely bidirectional, prioritizing mental health may help reduce CVD risk and improve CVH in young adults,” lead author Yaa A. Kwapong, MD, MPH, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, and co-authors said in the study. “Achieving the CVH‐related Sustainable Development Goals may necessitate the awareness of the physical health risks associated with depression and the prioritization of an integrated and comprehensive approach to tackling CVD and mental health disorders.”
Researchers examined self-reported data from 593,616 young adults aged 18–49 years in the United States collected in the 2017 to 2020 Behavioral Risk Factor Surveillance System (BRFSS) to determine the association of depression and poor mental health with CVD and CVH in this population.
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Exposures were defined as self-reported depression and poor mental-health days (PMHDs) broken into groups of 0, 1-13, and 14-30 days within the previous 30 days at the time of assessment. Self-reported CVD outcomes consisted of myocardial infarction, angina, or stroke. Suboptimal CVH outcomes comprised ≥2 of the following cardiovascular risk factors: hypertension, hypercholesterolemia, overweight/obesity, smoking, diabetes, physical inactivity, and inadequate fruit and vegetable intake.
Of the participants in the study, the weighted prevalence of depression was 19.6% (95% CI, 19.4–19.8), and the weighted prevalence of CVD was 2.5% (95% CI, 2.4–2.6). People with depression displayed higher odds of CVD than those without depression (odds ratio [OR], 2.32 [95% CI, 2.13–2.51]). After adjusting for sociodemographic and cardiovascular risk factors, participants with 1-13 PMHDs had 1.5‐fold odds of CVD (adjusted OR [aOR], 1.48 [95% CI, 1.34–1.62]), compared with participants who had 0 PMHDs. Participants with 14-30 PMHDs had even greater odds of CVD (aOR, 2.29 [95% CI, 2.08–2.51]). Biological sex and living in an urban or rural setting did not affect associations, researchers distinguished.
Study results are limited because BRFSS is based on self‐reported data, leaving the potential for recall bias and misclassification, authors noted. Additionally, “cardiovascular risk factors may be underreported in people with low literacy and because of social desirability and underdiagnosed in people who do not have access to health care.”
“Broader public policies should promote mental well‐being and healthy behaviors as part of a comprehensive strategy to reduce CVD burden among young adults,” researchers concluded.
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