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Heart Health Explained

Mental Health and Heart Health

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A scientific statement published by the American Heart Association in the journal Circulation on Jan. 25, 2021 confirmed that research shows a clear association between mental health and heart health and that interventions to improve psychological health can improve heart health.

Mental Health and Heart Health Q&A

What’s the most important thing people should know about this study as it relates to their health?
The mind, heart, and body are all interconnected and interdependent in their contribution to physical health and disease. There is growing evidence clearly showing associations between psychological health and overall wellness/well-being for patients. People should treat their mental health with the same type of seriousness as their physical health.
What was the intention behind this statement from the American Heart Association? Was this connection between mental and heart health not clear before?

The AHA commissioned a review of relevant research in this area and recognized the need to emphasize increased knowledge about the relationship between psychological health and heart and vascular health and disease. As a result of that review, the AHA released this scientific statement promoting the benefits of treating the patient as a whole person rather than focusing upon a specific physical condition.

What were the main points? What types of mental health have been studied, and what do we know about them?
Psychological health is an important part of overall wellness/well-being for patients. This scientific statement identifies various psychological states/traits and mental health conditions that can have either a negative or positive effect on cardiovascular risk and disease.

Psychological traits associated with a negative influence on cardiovascular disease include factors like chronic stress, loneliness, anger and hostility, and pessimism. Mental health conditions like anxiety, post-traumatic stress disorder, and depression have also been associated with increased cardiovascular disease risk. On the other hand, positive psychological traits such as optimism, a sense of purpose, happiness, and mindfulness have been linked with a lower risk for cardiovascular disease.

Additionally, increasing evidence points to a linkage between psychological health and other biological processes, like chronic inflammation, which can contribute to, cause, or worsen cardiovascular conditions. As scientists develop improved understanding of the links between specific emotional experiences and brain-body alterations, better, more targeted treatment strategies and interventions can be developed.
Did the statement cover any differences concerning individual differences?
The AHA scientific statement carefully reviewed a large number of studies in psychological health and cardiovascular health, risk, and disease. Individual psychological factors, personality traits, and mental health disorders were found to have greater or lesser influences upon various cardiovascular events and conditions.
Does the statement discuss the strengths and shortcomings of the state of research on this topic?
Many of the papers reviewed involved large study groups. A number of these studies used methods carefully designed to include objective measures of cardiovascular disease and adjust for variables that might inappropriately influence the findings. However, given the nature of human studies in this area, researchers often had to rely on less objective data, including observation and self-reporting of behaviors.
What, if anything, should people and health care professionals do differently in the face of these findings? What are the challenges to addressing this issue?

People should value and take care of their mental health as they do their physical health. Health care professionals should assess psychological factors (e.g., psychological distress versus positive psychological health) that may affect their patients’ health and wellness. For patients who exhibit signs of distress, deliberate steps should be undertaken to address these issues. These would include attempts to have an open discussion about symptoms and the impact of those symptoms on health and function. It would also include possible referral to and co-management with a mental health specialist to address psychological and/or behavioral concerns.

HEALTH NEWS IN PERSPECTIVE

Answers to your questions on timely topics in cardiac care to help make sense of research reports in the media. The series includes questions on your heart and the effect of medications, exercise, diet, and hormones.

Team Specialist

Dallas Erdmann, MD, System Medical Chief Behavioral Health, Department Chair, Riverside Methodist Hospital, OhioHealth Health System

Q&A Editor

Teresa Caulin-Glaser, MD, FACC, FAACVPR System Vice President, Heart & Vascular Services OhioHealth Healthcare System, Columbus, Ohio

Heart Health Explained is a collaboration of Women’s Health Research at Yale and the OhioHealth Healthcare System, a nationally recognized not-for-profit organization with providers across 46 counties, offering a holistic approach to prevention, treatment and rehabilitation of heart disease. OhioHealth is staffed by physicians, psychologists, nutritionists and nurses who answer the questions of the moment on heart and vascular health.

The information provided here may help you make more informed choices. However, it is not a substitute for an individualized medical opinion or diagnosis, and everyone should always consult with their personal physicians to make decisions about their condition or treatment.