People with mental health problems are “significantly” more likely to have stroke or heart disease, according to a study unveiled at a recent Canadian Cardiovascular Congress.
Furthermore, cardiovascular problems rise in tandem with the number of mental health problems per patient.
Katie Goldie, the Toronto Centre for Addiction and Mental Health doctor who led the study, told BioscienceTechnology, DDD’s sister publication, “The findings did not surprise me. I did this study because I observed a health disparity in clinical practice and wanted to draw attention to this issue on a population level.”
Mental health disorders at any juncture
Goldie analyzed data from the Canadian Community Health Survey in her quest to find links between mental health disorders, cardiovascular risk and disease and psychiatric medications.
Her team discovered that those with a mental health disorder at any juncture were twice as likely to have endured heart disease or stroke.
They also found that people with mental disorders who don’t have heart disease or stroke are more likely to be at a higher long-term future risk of cardiovascular disease than normal.
Additionally, people using psychiatric medications are twice as likely to have heart disease, and three times as likely to have a stroke as those not on those drugs.
Study participants had schizophrenia, bipolar disorders, major depressive and/or anxiety disorders, among other problems. Psychiatric medications studied included antidepressants (Zoloft), antipsychotics (Haldol and Zyprexa), mood stabilizers and benzodiazepines (Valium and Xanax).
Explaining the links
There are at least three possible explanations for the links.
First, people with mental health disorders can engage in risky behaviors: alcohol and tobacco abuse, physical inactivity and unhealthy diets. In Canada, 40% to 90% of those with mental illness use tobacco, while only 20% of the general Canadian population do so.
Then there is the fact that psychiatric drugs can prompt weight gain and impede the breakdown of fats and sugars, leading to obesity, high cholesterol and diabetes. This link is increasingly well documented. Other recent papers detailing an association between psychiatric medications and weight gain have appeared in the Journal of Clinical Psychiatry (anti-psychotics), the Journal of the American Medical Association Psychiatry (anti-depressants), and the Harvard Review of Psychiatry (bipolar disorder drugs).
Finally, the mentally ill can be plagued by communication issues on both sides of the psychiatrist’s couch, Goldie’s report indicated. The mentally ill can experience great difficulty articulating their own needs. But a lingering stigma, even in the professional community, can also apparently exacerbate communication problems. Patients with mental health disorders receive fewer cardiovascular disease risk-reducing drug therapies from their doctors. They also undergo fewer necessary surgical procedures, such as coronary bypass repair.
As one in five Canadians have experienced a mental health disorder in their lifetime— and as one in four Americans experience a mental illness each year— all this potentially impacts the cardiovascular health of millions.
The new Toronto research “was done to ultimately improve care for people with mental health disorders,” Goldie told Bioscience Technology. It will soon be submitted to a peer-reviewed journal for publication consideration. Conference reports are considered preliminary until acceptance by, and publication in, peer-reviewed journals.
Next up for Goldie is “another study examining more recent estimates of a variety of chronic diseases and health behaviors in people with mental illness,” she said to Bioscience Technology, DDD’s sister publication.
