Mental health disorders could be a driving factor in heart-related deaths. (© pixelheadphoto – stock.adobe.com)
Study Shows Anxiety, Depression, and Bipolar Disorder Strongly Tied to Early Heart Deaths
In A Nutshell
People with depression, schizophrenia, bipolar disorder, PTSD, and anxiety live 10–20 years less on average, mainly due to heart disease.
Risks: depression ↑72%, schizophrenia ↑95%, bipolar disorder ↑57%, PTSD ↑61%, anxiety ↑41%.
One in four people will experience a mental health disorder in their lifetime, but many go untreated and receive poorer cardiovascular care.
Exercise is one of the most effective treatments, improving both mood and heart health.
Integrated care is promising, but healthcare systems must stop treating mental and physical health as separate problems.
ATLANTA — People with depression, anxiety, schizophrenia, bipolar disorder, and PTSD face a hidden threat that kills more of them than suicide or overdoses: heart disease. Research shows these mental health conditions can shorten lifespans by 10 to 20 years, with cardiovascular disease becoming the leading cause of death in this population.
Depression increases heart disease risk by 72%, while schizophrenia nearly doubles it at 95% higher risk. Bipolar disorder raises cardiovascular risk by 57%, PTSD increases coronary heart disease risk by 61%, and anxiety disorders are linked to a 41% higher risk of cardiovascular mortality. Despite facing much higher heart disease rates, people with mental health disorders receive worse cardiovascular care than the general population.
The research, published in The Lancet Regional Health-Europe, examines how mental health conditions create massive health disparities. People with serious mental health disorders experience shortened lifespans of 10 to 20 years compared to the general population, with heart disease being the primary driver of this early mortality.
Mental Health and Heart Disease Feed Off Each Other
Mental health and cardiovascular disease create a harmful cycle that works both ways. Mental health disorders push people toward behaviors that damage the heart, including much higher smoking rates, reduced physical activity, and poor eating habits. The biological effects run even deeper.
Chronic stress linked to these conditions can drive harmful changes in the body. They include higher inflammation, elevated blood pressure, irregular heart rhythms, and problems with how the body processes insulin. Meanwhile, having a heart attack or stroke can spark new mental health problems, creating a two-way street between the mind and the heart.
The numbers show this two-way relationship clearly. Depression affects 18% of people with cardiovascular disease overall, but jumps to 28% after acute events like heart attacks. Nearly one in four stroke survivors develops depression, while 12% of heart attack survivors develop PTSD from their cardiac trauma.
What goes on in your head could be priming your heart for poor health. (© Nuthawut – stock.adobe.com)
Healthcare Systems Fail This Vulnerable Group
Healthcare typically treats mental health and heart disease as completely separate problems. Cardiologists often miss mental health symptoms, while psychiatrists may not monitor heart health adequately. People with mental health disorders have more healthcare contacts overall, yet receive fewer physical checkups, cardiovascular screenings, and heart disease treatments.
The paper cites troubling treatment gaps. According to 2023 U.S. survey data referenced in the study, 54% of Americans who met criteria for mental health disorders received no treatment. Among non-White populations, fewer than 45% received any mental health care.
Even in countries with universal healthcare, many people with mental health disorders don’t receive recommended cardiovascular treatments, including medications, procedures, and follow-up care. Poverty, unstable housing, and social isolation make the problem worse by creating additional barriers to quality healthcare.
Exercise and Integrated Care Show Promise
Standard mental health treatments can help reduce cardiovascular risk, though results vary across different approaches. Exercise shows particularly strong benefits for depression, with the research noting it should be considered as core treatment alongside psychotherapy and antidepressants. Exercise also provides direct cardiovascular benefits.
Mind-body practices including yoga, tai chi, and meditation show promise for both mental health symptoms and cardiovascular risk factors. However, most studies haven’t proven these interventions can prevent major cardiac events.
Integrated care programs that coordinate mental health and cardiovascular treatment have improved mental health outcomes in trials. But these programs haven’t yet demonstrated they can reduce heart attacks or cardiovascular deaths.
The researchers call for major healthcare system changes. Medical schools need to train doctors who understand connections between mental and physical health. Insurance systems must expand mental health coverage while ensuring cardiovascular screening access.
Most importantly, medical researchers must stop excluding people with mental health disorders from cardiovascular studies. This practice has left doctors without proper evidence-based guidelines for treating heart disease in this high-risk population.
Since approximately one in four people experience mental health disorders during their lifetime, addressing this crisis could prevent millions of premature deaths. Healthcare systems must stop treating mental and physical health as separate issues when the evidence shows they’re deeply connected.
Paper Summary
Methodology
This narrative review analyzed data from multiple academic databases from January 1, 2012 to July 1, 2024, focusing on recent studies, systematic reviews, and meta-analyses examining the relationship between mental health disorders and cardiovascular disease. Researchers prioritized large registry studies and meta-analyses published since 2017, examining both clinical interviews and self-reported symptom data from adult populations only.
Results
Mental health disorders significantly increase cardiovascular disease risk, with depression raising risk by 72%, schizophrenia by 95%, bipolar disorder by 57%, and PTSD by 61%. Mental health disorders affect approximately 25% of people during their lifetime, with cardiovascular disease being the leading cause of death in this population. People with mental health conditions experience shortened lifespans of 10-20 years and face significant healthcare disparities despite having more healthcare contacts.
Limitations
This narrative review relied primarily on published meta-analyses and registry studies that inconsistently adjusted for confounding factors. Many studies excluded people with mental health disorders or had limited participation from this population, potentially limiting understanding of effective interventions. The review also noted insufficient evidence for optimal screening methods and treatment approaches specifically designed for people with mental health disorders.
Funding and Disclosures
Dr. Chris Gale received grants and contracts from the Alan Turing Institute, the British Heart Foundation, the National Institute for Health Research, Horizon 2020, Abbott Diabetes, Bristol Myers Squibb, and the European Society of Cardiology; consulting fees or honoraria from AI Nexus, AstraZeneca, Amgen, Bayer, Bristol Myers Squibb, Boehrinher-Ingleheim, CardioMatics, Chiesi, Daiichi Sankyo, GPRI Research B.V., Menarini, Novartis, iRhythm, Organon, The Phoenix Group, Boston Scientific, Raisio Group, Wondr Medical, and Zydus; and participation in advisory boards for the DANBLCOK trial and the TARGET CTCA trial. He received equipment from Kosmos and serves as Deputy Editor of EHJ Quality of Care and Clinical Outcomes; he serves in the NICE Indicator Advisory Committee, and as Chair of the ESC Quality Indicator Committee. Dr. Bugiardini declares participation in advisory board for NCT05758896 (Contrast Induced Acute Kidney Injury, Aptabio Therapeutics, Inc.). Dr. Viola Vaccarino declares participation in Data Safety Monitoring Boards for NIH studies (ARIC and Connect 4R). No specific funding was received for the preparation of the manuscript.
Publication Information
This paper was published in The Lancet Regional Health – Europe, Volume 56, September 2025, as part of a series on “Inequalities and Disparities in Cardiovascular Health.” The study was titled “Mental health disorders and their impact on cardiovascular health disparities” and was authored by an international team of researchers led by Viola Vaccarino from Emory University.