Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States

Abstract

Background Depression is a nontraditional risk factor for cardiovascular disease (CVD). Data on the association of depression and poor mental health with CVD and suboptimal cardiovascular health (CVH) among young adults are limited. Methods and Results We used data from 593 616 young adults (aged 18–49 years) from the 2017 to 2020 Behavioral Risk Factor Surveillance System, a nationally representative survey of noninstitutionalized US adults. Exposures were self‐reported depression and poor mental health days (PMHDs; categorized as 0, 1–13, and 14–30 days of poor mental health in the past 30 days). Outcomes were self‐reported CVD (composite of myocardial infarction, angina, or stroke) and suboptimal CVH (≥2 cardiovascular risk factors: hypertension, hypercholesterolemia, overweight/obesity, smoking, diabetes, physical inactivity, and inadequate fruit and vegetable intake). Using logistic regression, we investigated the association of depression and PMHDs with CVD and suboptimal CVH, adjusting for sociodemographic factors (and cardiovascular risk factors for the CVD outcome). Of the 593 616 participants (mean age, 34.7±9.0 years), the weighted prevalence of depression was 19.6% (95% CI, 19.4–19.8), and the weighted prevalence of CVD was 2.5% (95% CI, 2.4–2.6). People with depression had higher odds of CVD than those without depression (odds ratio [OR], 2.32 [95% CI, 2.13–2.51]). There was a graded association of PMHDs with CVD. Compared with individuals with 0 PMHDs, the odds of CVD in those with 1 to 13 PMHDs and 14 to 30 PHMDs were 1.48 (95% CI, 1.34–1.62) and 2.29 (95% CI, 2.08–2.51), respectively, after adjusting for sociodemographic and cardiovascular risk factors. The associations did not differ significantly by sex or urban/rural status. Individuals with depression had higher odds of suboptimal CVH (OR, 1.79 [95% CI, 1.65–1.95]) compared with those without depression, with a similar graded relationship between PMHDs and suboptimal CVH. Conclusions Depression and poor mental health are associated with premature CVD and suboptimal CVH among young adults. Although this association is likely bidirectional, prioritizing mental health may help reduce CVD risk and improve CVH in young adults.

Depressive Symptoms and Mortality Among US Adults

“…Our findings about overall associations between depression and mortality risk are consistent with previous study results . A study using the 1999 National Health Interview Survey linked with mortality data through 2011 showed that, adjusting for demographic factors, anxiety or depression was associated with 61% elevated risk of mortality .…”

“…In 2020, an estimated 21 million US adults (8.4%) had at least 1 major depressive episode . Numerous adverse outcomes have been associated with depression, including increased cardiovascular disease (CVD) incidence and premature mortality . The onset of CVD occurs an average of 7.5 years earlier in adults with mood disorders, and people with severe mental disorders, including moderate to severe depression, die an average of 10 to 20 years earlier than the general population .…”

Impact of comorbid opioid use disorder and major depressive disorder on healthcare utilization outcomes in patients with peripheral artery disease: A National Readmission Database analysis

“…This is consistent with other studies that have posited MDD as a significant risk factor for adverse cardiovascular events. [34][35][36] The elevated rates of STEMI and NSTEMI in this group further underscore the critical need for targeted cardiovascular monitoring in patients with MDD. Furthermore, data revealed that the highest major amputation rate was in patients with both OUD and MDD, followed by those having only OUD and No MDD.…”

Risk of cardiovascular diseases among young adults: a cross-sectional study in Malaysia

“…Multiple physiological pathways, including disruptions in glucose and lipid regulation, as well as abnormalities in the coagulation cascade due to chronic stress, serve as mechanisms through which psychological well-being influences cardiovascular health and CVD risk 42. Hence, prioritising mental health may assist in CVD risk reduction in young adults 43…”