Association between heart disease and mental health outcomes: analysis of the Australian Ten-to-Men Nationwide Longitudinal Study

BACKGROUND: Heart disease and mental health disorders are major public health challenges. This study examines the association between heart disease, depression, and anxiety disorders, highlighting significant risk factors. METHODS: Data from four waves (2014-22) of the Ten-to-Men longitudinal study were analysed. Heart disease was assessed via self-reported medical diagnoses, while depression and anxiety disorders were measured using PHQ-9 and GAD-7. Generalized Estimating Equation models examined associations, adjusting for demographic, lifestyle, and comorbid factors. RESULTS: Among 16 021 participants at baseline, the prevalence of depression (22.5%-25.5%), anxiety disorders (13.8%-47.3%), and their co-occurrence (8.1%-21.4%) increased significantly (P < .001). Heart disease was associated with higher risks of depression (RR = 1.15, 95% CI: 1.02-1.31), anxiety disorders (RR = 1.31, 95% CI: 1.15-1.49), and their co-occurrence (RR = 1.35, 95% CI: 1.12-1.62). Smoking, obesity, diabetes, and hypertension exacerbated these risks, while being married/de facto was associated with a lower likelihood of depression (RR = 0.74, 95% CI: 0.69-0.79) and anxiety disorders (RR = 0.82, 95% CI: 0.76-0.87). CONCLUSION: Heart disease is associated with an increased likelihood of depression and anxiety disorders among Australian males. These findings inform public health strategies for integrated heart and mental health interventions that target individuals at risk due to lifestyle factors.