Stress-related Disorders Raise Risk for Heart Attack, Stroke

If you have a stress-related disorder, such as post-traumatic stress disorder (or PTSD), acute stress reaction or adjustment disorder, you may have a higher risk for developing cardiovascular disease, according to a study published in The BMJ.

Many people develop a stress-related disorder after dealing with a stressful situation such as death, divorce or illness. Others develop them after exposure to a traumatic event like war, natural disaster or violence. For instance, 67 percent of people who witness mass violence develop PTSD, and between 3 and 33 percent of people who experience one or more traumas develop acute stress reaction.

Previous studies found veterans with PTSD to have a higher risk for cardiovascular disease, but the studies were small and limited to armed services personnel. Swedish researchers wanted to expand on this earlier work to see if the risk for cardiovascular disease was limited to combat veterans or anyone dealing with extreme stress. 

Researchers reviewed records from Swedish population and health registries. After controlling for family history, personal medical history and underlying mental health conditions, researchers matched almost 137,000 records of Swedish residents diagnosed with a stress-related disorder between January 1987 and December 2013 with more than 170,000 siblings without a stress-related disorder or cardiovascular disease. 

For each person diagnosed with a stress-related disorder and cardiovascular disease, 10 people from the general population without either condition were randomly selected. Both groups of people were individually matched by birth year and gender.

Just as researchers suspected, stress disorders contributed to the development of cardiovascular disease and raise the risk for cardiac arrest and heart attack. In fact, being diagnosed with a stress-related disorder raised the risk of a cardiac event by 64 percent compared to siblings without stress issues within in the first year of diagnosis. And those with a stress-related disorder had a strong chance of developing cardiovascular disease before age 50, compared to unaffected siblings.   

“Yes, this is an observational study, so it can’t explain cause and effect. As of now, researchers have not made a direct connection between stress disorders and cardiovascular disease,” says Bernard Kaminetsky, MD, medical director, MDVIP. “But the findings don’t surprise me. Stress and stress-related disorders often lead to an unhealthy lifestyle, which takes a toll on the cardiovascular system.” 

In another recent study, researchers looked for a specific connection between PTSD and cardiovascular disease. They reviewed medical records of 4,178 cardiovascular disease-free Veterans Affairs patients -- 2,519 of whom had PTSD and 1,659 who did not. After following patients for three years, researchers found PTSD patients were 41 percent more likely to develop cardiovascular disease than their counterparts without PTSD. They also found no single condition led to the development of cardiovascular disease; it was a combination of smoking, depression, anxiety disorders, psychiatric disorders, sleep disorders, substance use disorders, type 2 diabetes, obesity, high blood pressure and high cholesterol, according to the study published in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

“When you’re stressed and anxious, it’s common to want a drink, a cigarette or some unhealthy food – lifestyle behaviors that raise the risk for heart attacks and stroke,” Kaminetsky says. “ 

If you’ve been diagnosed with a stress-related disorder, work with your doctor to help you maintain a healthy lifestyle and prevent cardiovascular disease. If you don’t have a primary care physician, consider partnering with an MDVIP-affiliated physician. MDVIP doctors have the time to work with you to help you prevent and control cardiovascular disease. Find a physician near you and begin your partnership in health »