Having A Mental Health Disorder Doubles Stroke Risk

Individuals with mental health challenges are much likelier to develop heart disease or experience a stroke, according to a new study.

Lead author Katie Goldie, PhD, RN, a postdoctoral fellow at the Centre for Addiction and Mental Health in Toronto, and colleagues examined the association between cardiovascular risk and disease, mental health disorders, and the use of psychiatric medication. The study, which included participants with schizophrenia, bipolar disorders, and major depressive and anxiety disorders, examined antipsychotic, depressant, benzodiazepine, and mood-stabilizing medications.
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Goldie and her co-authors found that individuals who have had a mental health disorder at some point in their lives were twice as likely to have had heart disease or suffered a stroke. Meanwhile, those who haven’t developed heart disease or had a stroke are more likely to be at long-term risk of developing cardiovascular disease, in comparison to the general population. In addition, participants using psychiatric medications were twice as likely to have heart disease, while their likelihood of experiencing a stroke was triple that of those not taking such medications.

Goldie cited 3 main factors for these elevated risks: people with mental health disorders tend to exhibit behavioral risk factors such as tobacco and alcohol use, poor diet, and physical inactivity; access to healthcare, and the fact that psychiatric medications can induce weight gain and impair the breakdown of sugar and fats by the body.

Primary healthcare providers have the capacity to combat this health inequity, however, “by placing special emphasis on routinely monitoring physical health signs and symptoms, e.g., weight, blood pressure, and fasting glucose and lipids) in this population,” says Goldie.

Primary care practitioners can also offer behavioral education and interventions, in the form of diet, exercise, and smoking cessation counseling, as well as promoting healthful lifestyles through advocating for continued funding of new and existing health promotion programs, she says.

To tackle systemic barriers to physical healthcare provision, improved integration of primary and mental healthcare services is needed,” says Goldie, “to better address the complex care needs of people who have both mental and physical illnesses and to strengthen continuity of care.”

The findings were originally presented at the 2014 Canadian Cardiovascular Congress, held Oct. 25 – 28 in Vancouver, B.C.

—Mark McGraw