New research using the Sax Institute’s 45 and Up Study is helping to explain the link between depression and ischaemic heart disease (IHD), showing that psychological distress in middle-aged and older people may signal the early signs and symptoms the disease.
The researchers said it was known that people who experience psychological distress – which includes symptoms of depression and anxiety − had an increased risk of developing IHD, but it was unclear whether the distress caused IHD, or whether underlying but undiagnosed IHD resulted in symptoms of distress.
To analyse the association, they linked data on psychological distress from more than 150,000 participants in the 45 and Up Study without a history of diagnosed cardiovascular disease with hospital and morality data.
The 45 and Up Study is Australia’s largest cohort study, following the health of more than 250,000 NSW men and women aged over 45 years to enable researchers to answer questions about our ageing population.
The research findings, published recently in the Journal of Epidemiology and Community Health, showed that the risk of IHD was elevated among those with mild, moderate and high (compared to low) levels of distress.
A marker of disease risk
However, a substantial part of the association between distress and IHD was explained by behaviour-related risk factors such as smoking, exercise, alcohol, weight and diabetes, as well as by people’s functional limitations (limited ability to perform every day activities), which can be used as an indicator of the presence of underlying ischaemic heart disease.
In people without functional limitations, there was only a weak association between distress and IHD, suggesting that psychological distress should be viewed as a marker of increased IHD risk, rather than a cause of the disease.
“Psychological distress maybe better considered a healthcare need and risk marker for IHD, rather than a risk factor,” the researchers wrote.
The findings highlighted the potential for placing a greater focus on psychological distress as an indicator of healthcare need.
“Psychological distress may be a marker of underlying disease processes, but more importantly, may signal less healthy behaviours, and provide a useful trigger for health professional to conduct CVD risk assessment and provide lifestyle interventions,” they wrote.
Find out more
- Read the paper: Psychological distress and ischaemic heart disease: cause or consequence? Evidence from a large prospective cohort study (Subscription required for full text)
- Read the researchers’ blog in The Conversation: No, depression won’t literally break your heart (but have a heart check anyway)
- See more news from the 45 and Up Study