Key result
High psychological distress linked to ~28% greater risk of incident CVD.
Why the study?
The science linking psychological distress to CVD risk required updated synthesis for practice recommendations, and whether screener-identified distress is associated with incident CVD was unknown.
Does high psychological distress increase the risk of incident cardiovascular disease in adults without a past psychiatric diagnosis?
Meta-Analysis (n=658,331)
Does high psychological distress increase the risk of incident cardiovascular disease in adults without a past psychiatric diagnosis?
Effect estimate: 28% greater risk
Rapid screening for psychological distress identifies individuals at a 28% greater risk for incident cardiovascular disease, highlighting its utility in CVD prevention.
Supports distress screening in CVD prevention; extends meta-analytic evidence linking psychological factors to incident disease.
BACKGROUND: Psychological distress-elevated symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), or psychosocial stress-has been associated with risk for cardiovascular disease (CVD). Despite increasing attention to the importance of these factors for CVD prevention, the state of this science requires updated synthesis to enable practice recommendations. Moreover, it is unknown whether psychological distress based on screeners, validated self-report instruments that efficiently identify those who may require mental health services or additional support, is associated with incident CVD. METHODS: MEDLINE, Embase, and PsycInfo were searched for studies published 2017-2022, including adults without a past psychiatric diagnosis, who were screened at baseline for depression, anxiety, PTSD, stress, or general mental health symptoms, and followed for >6 mo to determine their risk for incident CVD (ie, atrial fibrillation, acute coronary syndrome, coronary heart disease, peripheral vascular disease, heart failure, or a composite). A meta-analysis was used to aggregate results to determine whether clinically significant levels of psychological distress were associated with CVD onset. RESULTS: The search identified 28 investigations that represented 658 331 participants (58% women). Fifteen studies had adequate data for the primary meta-analysis, which indicated that those reporting high psychological distress showed a 28% greater risk of incident CVD compared with those with low or no distress. CONCLUSIONS: Rapid screening for psychological distress is a helpful and efficient approach to understanding the CVD risk profile of an individual. Additional investigations are needed to improve prospective evidence concerning psychosocial stress. Conducting analyses by sex may better elucidate the benefits of psychological distress screening for men and women, respectively, and encourage more widespread adoption in CVD prevention.
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Gaffey et al. (2022) conducted a meta-analysis in Psychological distress (n=658,331). High psychological distress vs. Low or no psychological distress was evaluated on Incident cardiovascular disease (28% greater risk). High psychological distress identified via screening was associated with a 28% greater risk of incident cardiovascular disease compared with low or no distress.
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