Young women are generally thought to be at lower risk for heart disease, but new research is urging clinicians to reconsider that assumption, especially for women who suffer from certain mental health conditions. A new study presented at the American College of Cardiology's Annual Scientific Sessions finds that having anxiety and depression may accelerate the development of cardiovascular risk factors in young and middle-aged women. did.
This study draws new attention to the importance of cardiovascular screening and preventive care as rates of cardiovascular risk factors rise and heart attacks become more common in younger people. Anxiety and depression have also become more prevalent in recent years, especially since the COVID-19 pandemic.
Researchers found that young women with anxiety and depression were almost twice as likely to develop high blood pressure, high cholesterol, and diabetes over a 10-year period compared to women without these mental health conditions. They reported that they were almost on par with men. They are the same age when it comes to heart disease risk.
We often feel that young women are a “safe group” when it comes to cardiovascular disease because they have a very low incidence of cardiovascular disease due to the protective effects of estrogen. However, this study suggests that if young women suffer from depression or anxiety, they should begin screening for cardiovascular risk factors to reduce the incidence of cardiovascular disease. ”
Giovanni Sivieri, MD, cardiologist, researcher at Massachusetts General Hospital and Harvard Medical School, doctoral student at the University of Padua, Italy, and lead author of the study
Researchers analyzed the health records of 71,214 people participating in the Mass General Brigham Biobank, a research program of the Mass General Brigham Health System. People were excluded if they had heart disease or were diagnosed with anxiety or depression after the study began.
During the 10-year follow-up period, 38% of participants developed high blood pressure, high cholesterol, and/or diabetes. The analysis found that people with a history of anxiety or depression before the study period were about 55% more likely to develop one or more of these risk factors compared to people without anxiety or depression. Ta. This finding was most pronounced in women under age 50 with anxiety or depression, who were almost twice as likely to develop cardiovascular risk factors compared to other groups.
In terms of absolute risk, young women overall had the lowest rates of cardiovascular risk factors of any group, given previous research and what is known about the protective effects of estrogen in premenopausal women. This was expected. However, anxiety and depression were associated with much higher relative risks among young women compared to other groups.
“Once a young woman develops depression or anxiety, her absolute risk is the same as that of a young man,” Sivieri says. “There's a kind of catch-up phenomenon where depression and anxiety are increasing the risk that would otherwise be very low.”
To study the potential factors behind this relationship, researchers examined metabolic activity in stress-related brain regions in a subset of participants who underwent brain scans. The results showed that young women with anxiety and depression had relatively large increases in stress-related neural activity.
“The question is why anxiety and depression are associated with increased risk in young women. This is something we continue to study,” Sivieri said.
Although anxiety and depression are separate conditions, they were grouped together in the study because they are both associated with increased cardiovascular risk and share common neurobiological pathways. That is, they are thought to affect health in similar ways.
Researchers say it's unclear whether mental health treatments such as antidepressants and psychotherapy can help reduce cardiovascular risk. But once a person has high blood pressure, high cholesterol or diabetes, established treatments such as statins and blood pressure-lowering drugs can effectively reduce the risk of serious cardiac events, Sivieri said.
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American College of Cardiology
