Mental health screening may be the missing link in heart safety, says study

A global review of data from over 22 million people links mental disorders to higher risks of heart attacks, suggesting mental health screening may need to become part of routine heart disease prevent

Cardiovascular disease remains one of the world’s leading causes of death, yet efforts to improve heart safety may be missing an important piece of the puzzle. 

A new systematic review titled Mental disorders as a risk factor of acute coronary syndrome, published in JAMA Psychiatry, examined data from over 22 million people and found that several mental health conditions are associated with a significantly increased risk of acute coronary syndrome, a term encompassing heart attacks and related emergencies. 

The findings signal a shift in preventive cardiology, where mental well-being may need to be taken as seriously as blood pressure and cholesterol levels.

What the study found about mental illness and heart attack risk

The large-scale analysis, led by the Department of Medicine at the University of Calgary, highlighted several key findings:

• Substance use disorder: People with substance use disorders were more than twice as likely to experience a heart attack compared with those without the condition (odds ratio 2.41; very low certainty)
• Post-traumatic stress disorder (PTSD): Individuals with PTSD had nearly a threefold higher heart-related risk (hazard ratio 2.73; moderate certainty)
• Anxiety disorders: Anxiety was linked to a 63 per cent higher risk of heart attack (hazard ratio 1.63; low certainty)
• Depressive disorders: Depression was associated with a 40 per cent increased risk of acute coronary syndrome (hazard ratio 1.40; very low certainty)
• Sleep disorders: These were also linked to a higher risk, with affected individuals facing a 60 per cent increased likelihood of acute coronary syndrome (hazard ratio 1.60; low certainty)

The terms low certainty and very low certainty indicate that while an association was observed, the strength of evidence is limited due to variations in study design or data quality, and further research is needed to confirm these links. 

The study also noted that many participants developed heart events years after their mental health diagnosis, suggesting a window for prevention.

Why mental health affects heart safety

Mental health conditions influence heart health through multiple biological and behavioural pathways, including:

• Persistent stress responses that keep blood pressure and heart rate elevated over time
• Hormonal imbalances that promote inflammation and damage blood vessels
• Disrupted sleep patterns that interfere with metabolism and cardiovascular recovery
• Reduced motivation for physical activity and healthy eating
• Higher likelihood of smoking, alcohol or substance use, and poor medication adherence

Over time, these factors can accelerate atherosclerosis and increase vulnerability to acute cardiac events.

Why mental health screening makes sense in routine heart care

Mental health screening is increasingly being seen as both practical and impactful because:

• It can be incorporated into regular health check-ups
• Validated tools such as Patient Health Questionnaires (PHQ) are already widely available
• Early detection allows timely counselling, treatment or lifestyle support
• Psychological care may help reduce long-term cardiovascular risk

This holistic model encourages closer collaboration between cardiologists, primary care doctors and mental health professionals, ensuring that patients with heart concerns are also assessed for psychological distress. 

Addressing mental health early, the study suggests, could prevent years of suffering and reduce the burden on healthcare systems by lowering rates of heart disease and cardiac emergencies.

  For more health updates, follow #HealthwithBS  This report is for informational purposes only and is not a substitute for professional medical advice.