Depression, Anxiety May Raise Heart Attack Risk, Global Study Finds

Mental health problems are often seen as conditions affecting only the mind, but growing evidence shows they can quietly raise the risk of serious physical illnesses too—including heart attacks. A large international study reviewing the health of 22 million people has found that those living with certain mental health disorders face a higher risk of developing acute coronary syndrome (ACS), a medical term that includes heart attacks and severe chest pain caused by reduced blood flow to the heart.

The findings are important because ischemic heart disease—which includes heart attacks—remains one of the leading causes of death and disability worldwide, including in India. While doctors have long focused on controlling risk factors such as high blood pressure, diabetes, obesity, and high cholesterol, this study conducted by a multidisciplinary team of researchers led by Dr. Arnav Gupta from the Department of Medicine, University of Calgary highlights that mental health disorders may also play a role in heart disease risk.

The researchers reviewed existing global evidence to understand whether mental health disorders diagnosed earlier in life increase the chances of a future heart emergency. They analyzed studies published in major medical databases such as MEDLINE, Embase, and PubMed, focusing only on those where mental disorders were clinically diagnosed using standard criteria and where heart events occurred later.

Out of over 3,600 studies initially screened, 25 high-quality studies were included, covering more than 22 million people. About 13 percent of participants had at least one diagnosed mental health disorder, and 1.4 percent experienced an acute coronary event during the study period.

The analysis ‘Mental Disorders as a Risk Factor of Acute Coronary Syndrome’ showed that people with depression, anxiety disorders, post-traumatic stress disorder (PTSD), and sleep disorders had a higher risk of heart attacks or acute heart-related chest pain compared to those without these conditions.

Among all disorders studied, PTSD showed the strongest link, with people affected having nearly three times higher risk of heart attack. Sleep disorders and anxiety disorders were also linked to significantly higher risk, while depression showed a modest but concerning increase. Some conditions, such as bipolar disorder and psychotic disorders, did not show clear associations, largely because of inconsistent or limited data rather than proof of no risk.

Mental health disorders often overlap with well-known heart risk factors. People struggling with anxiety, depression, or sleep problems may have higher rates of smoking, physical inactivity, poor diet, obesity, diabetes, and high blood pressure. Beyond lifestyle, mental stress can trigger chronic inflammation, hormonal imbalance, and exaggerated stress responses, all of which strain the heart and blood vessels.

Poor sleep—common in both PTSD and depression—has been linked to poor sugar control, increased oxidative stress, and metabolic disturbances, further increasing heart disease risk.

These findings, published in the latest edition of the journal JAMA Psychiatry, are especially relevant for India, where the mental health burden is large and growing, yet remains under-recognized and under-treated. According to national estimates, nearly one in seven Indians lives with some form of mental health condition, but treatment gaps exceed 70 percent in many states due to lack of awareness, stigma, and shortage of trained professionals.

India also faces a parallel crisis of early-onset heart disease, with heart attacks occurring nearly a decade earlier than in many Western countries. The coexistence of untreated mental illness and rising cardiovascular disease creates a dangerous double burden, particularly among young and working-age adults.

“The study underlines an important message: mental health disorders are not limited to emotional suffering; they place real biological stress on the heart. Early recognition and treatment of conditions like depression, anxiety, trauma, and sleep disturbance are essential not only for psychological wellbeing but also for preventing heart disease.”

“For India, integrating mental health screening into routine primary care and heart disease prevention programs could be a crucial step toward reducing avoidable deaths,” pointed out Dr. Sunil Kumar, a clinical psychologist and founder of Mind Zone.