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How Do Mental Health Disorders Affect the Heart?
Depression, stress, schizophrenia and more can increase your risk of heart disease
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Here’s one more reason to take mental health seriously: People with untreated mental health conditions face an increased risk of heart disease, including risk of an eventual heart attack.
This link matters for a large portion of older adults. Nearly 1 in 7 U.S. residents over age 50 is living with a mental health disorder.
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A 2025 review in the Lancet Journal Health suggests that people with depression, anxiety, schizophrenia, bipolar disorder or post-traumatic stress disorder face substantially higher odds of developing cardiovascular disease. This risk can stem from lifestyle, biological response and access to health care.
The review found that those with major depression are 72 percent more likely to develop cardiovascular disease, including conditions like heart attack, heart failure and stroke. The risk was also elevated for other mental health conditions: 95 percent higher for schizophrenia, 57 percent for bipolar disorder, 61 percent for PTSD and 41 percent for anxiety disorders.
“Lots of people have this kind of comorbidity,” says Dr. Viola Vaccarino, lead author of the paper and chair of cardiovascular research at Emory University Rollins School of Public Health.
“Since cardiovascular disease predominantly affects people over 50, this demographic bears the heaviest burden,” she says.
Mental health conditions are common
Millions of older adults live with one or more mental health conditions.
Depression, marked by persistent sadness and loss of interest or pleasure in activities, can make people less likely to be physically active, maintain a healthy diet or have the motivation to quit smoking—challenges also common in other conditions like anxiety. These poor lifestyle habits are bad for your heart.
Mental health conditions also change what is happening inside our bodies. For example, depression can affect the inflammatory response—the body’s protective immune defense triggered by injury or infection — and the sympathetic nervous system — known as the “fight-or-flight” response to danger or stress, which can put a strain on the heart. Anxiety disorders can also affect your heart, including raising your heart rate and blood pressure. Research shows that anxiety can trigger chronic activation of stress hormones.
“We know that several of the common mental health conditions in the population are often a consequence of stress,” Vaccarino says. “The management of stress and mental health issues are mentioned here and there in [cardiovascular health] guidelines, but it’s not emphasized at all.”
Here are some ways to approach your mental health and manage stress for a healthy heart:
- Stuff your day with mood-boosting activities, says Dr. Waguih IsHak, professor and vice chairman of the psychiatry department at Cedar Sinai Medical Center. It’s called behavioral activation therapy. Patients work with a therapist to create a personalized schedule filled with simple things that bring them joy — like taking a walk, listening to music or having lunch with a friend. “If I’m not into exercise or if I’m not into meditation, it’s going to be hard to force me,” IsHak says. “Activities that make them happy are really what’s going to be the driver.”
- Stay connected. Research shows that social connection is strongly linked with better heart outcomes. Relying on your existing connections “or creating social supports can be really helpful,” says Dr. Jeff Huffman, director of the cardiac psychiatry research program at Massachusetts General Hospital. Whether it’s finding a friend to walk with or someone to talk to, those connections matter.
- Keep learning. IsHak recommends staying mentally active, again, choosing things you enjoy. That can be puzzles, reading or picking up a new hobby. Retirement can lead to mental inactivity due to loss of routine and professional purpose, but volunteering is another great way to stay cognitively active.
- Try mind-body practices. The Lancet Journal Health review highlights mind-body approaches — techniques that promote health through interactions between brain and body — as beneficial for treating mental health conditions. One example is yoga, which involves stretching, meditation and controlling your breath. In addition to beneficial effects for the mind, yoga can improve blood pressure, cholesterol and BMI, which are risk factors for cardiovascular disease.
- Manage your stress. Persistent stress over an extended period can lead to increased risk of mental health problems like anxiety and depression, as well as cardiovascular disease, Vaccarino says. Stress plays a key role in both mental health and cardiovascular health, and there may be more stressors to face later in life. Chronic stress can also lead to high levels of cortisol — a stress hormone that raises blood sugar, blood pressure and heart rate. Over time, this can contribute to cardiovascular problems.
- Make healthy lifestyle choices. The review emphasizes a healthy lifestyle including eating a healthy diet, stopping smoking, getting good sleep and — most importantly exercise. Exercise is recommended as a core treatment for depression and has direct cardiovascular benefits, so it targets both at the same time. “If you exercise, it's as effective to treat depression, for example, as an antidepressant. And at the same time, we know exercise is one of the main ways to manage cardiovascular risk,” Vaccarino says.
What if a heart attack brings on depression?
“I wasn’t depressed until my heart attack.” You’re not alone.
Rates of depression, PTSD and anxiety disorders are especially high, with up to 1 in 3 people experiencing depression after a major cardiac event, like heart failure or heart attack, according to Dr. Jeff Huffman, director of the cardiac psychiatry research program at Massachusetts General Hospital.
And that’s bad news. If you’re depressed after a heart attack, you’re more likely to have another heart attack than someone who also had a heart attack but did not have a mental health condition afterward, according to a scientific statement Huffman coauthored for the American Heart Association.
He’d like to see more mental health check-ins for cardiac patients. “It’s an added reason to really assess for and try to treat depression or anxiety or other mental health conditions after a cardiac event,” Huffman says.
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