Cardiovascular disease (CVD) and mental illness are major contributors to the global burden of disease. CVD is a major cause of death around the world, of which ischaemic heart disease (IHD) or coronary artery disease (CAD) accounts for 7.4 million deaths. IHD is a condition where the accumulation of plaques in the arteries affects blood circulation to the heart. The risk factors for developing IHD include:
- Hypertension (including arterial hypertension)
- Physical inactivity
- Elderly age
- Male gender
- History of IHD in the family
Mental illness or mental distress are terms that include a range of experiences and symptoms in a person’s life that are said to be confusing or troubling. A person in mental distress may show symptoms such as anger, anxiety, confused emotions, hallucination and depression without actually being “ill” in the medical sense, while mental illness constitutes a group of medically defined symptoms or conditions. Apart from disease, other situations that can affect an individual mentally are:
- Loss of loved ones
- Lack of sleep
- Use of alcohol or drugs
The relation between ischaemic heart disease and mental illness
Studies show that a relationship between mental illness and IHD does exist. People with a mental condition may be at an increased risk of developing IHD. Similarly, patients with IHD may also show an increased prevalence of mental disorders.
Commonly seen mental illnesses in patients with heart diseases are:
- Anxiety disorder
- Post-traumatic stress disorder
- Bipolar disorder
Depression is one of the common illnesses that has affected 300 million people of all age groups across the world. In comparison to the general population, the prevalence of depression in CAD patients is found to be higher in women than men. Multiple reports confirm that depression is a risk factor for IHD and associated health conditions and mortality. Most of this research on the association of IHD and depression was conducted in Western countries.
Schizophrenia significantly impacts the risk of CVD. Generalised anxiety disorder, a subtype of anxiety disorder, is also found to cause major heart events in patients with IHD. The association between mental disorders and IHD is often complicated, and the exact mechanism of how mental health disorders contribute to IHD is not fully understood. However, the increased risk of IHD in people with mental problems can be attributed to various biological, psychological, behavioural and genetic mechanisms.
Tips for patients with ischaemic heart disease who have a mental illness
Patients with IHD and mental illness should try and follow the below tips to help cope with the effects of these conditions:
- Exercise: Moderate-intensity aerobic exercise for at least 30 minutes a day, activities like walking on a treadmill, cycling, swimming, jogging, stair climbing and brisk walking.
- Meditation: It helps to calm the mind and should be started in small periods, e.g., 10 minutes at a time.
- Breathing exercises: Doing breathing exercises regularly for 10-15 minutes is helpful.
- Medication: As per the prescription of your doctor.
- Cognitive behavioural therapy (CBT): CBT helps the patients identify emotional responses that are caused by external thoughts. CBT is good for patients with stress, depression and anxiety.
More studies are needed to understand the exact mechanism of increased risk of IHD in a person with mental disorders, which can help in development of prevention and treatment strategies for the condition.
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- Ormel J, Von Korff M, Burger H, Scott K, Demyttenaere K, Huang YQ, et al. Mental disorders among persons with heart disease – results from the World Mental Health surveys. Gen Hosp Psychiatry. 2007 July-Aug;29(4):325-34. doi: 10.1016/j.genhosppsych.2007.03.009.