Teenagers and adolescents who are battling depression and anxiety may be at a higher risk of having a heart attack by midlife. Researchers found that depression or anxiety in adolescence is linked with a 20% greater likelihood of having a heart attack by middle age.
The research team investigated whether conditions like depression in adolescence (age 18 or 19) are associated with a higher risk of cardiovascular disease in adulthood. The authors also examined the possible role of stress resilience — which is the ability to cope with stress in everyday life — in helping to explain any associations.
The study involved 238,013 men born between 1952 and 1956. They underwent extensive examinations in late adolescence as part of their assessment for compulsory military service and were then followed into middle age, that is, up to the age of 58 years. The assessments at the age of 18 or 19 years included medical, psychiatric and physical examinations by physicians and psychologists.
Stress resilience was measured by an interview with a psychologist and a questionnaire and based on familial, medical, social, behavioral and personality characteristics.
The analysis revealed that 34,503 men were diagnosed with a non-psychotic mental disorder such as depression or anxiety. The team conducted follow-up for cardiovascular disease through hospital medical records. They found that a mental disorder in adolescence was associated with the risk of having a heart attack by middle age.
Compared to men without mental illness in adolescence, the risk of heart attack was 20% higher among men with a diagnosis. This is even after taking into account other characteristics such as blood pressure, body mass index, general health, and parental socioeconomic status, says the study which was released at the European Society of Cardiology (ESC) Congress 2020.
According to the study author, Dr Cecilia Bergh from the Örebro University in Sweden, patients need to be vigilant and look for signs of stress, depression or anxiety that is beyond the normal teenage angst and seek help if there seems to be a persistent problem.
The findings suggest that the association between mental illness and heart attack was partly, but not completely, explained by poorer stress resilience and lower physical fitness in teenagers with a mental illness.
“We already knew that men who were physically fit in adolescence seem less likely to maintain fitness in later years if they have low-stress resilience. Our previous research has also shown that low-stress resilience is also coupled with a greater tendency towards addictive behavior, signaled by higher risks of smoking, alcohol consumption, and other drug use,” says Dr Bergh.
The author suggests that if a healthy lifestyle is encouraged as early as possible in childhood and adolescence, it is more likely to persist into adulthood and improve long-term health.
“Better fitness in adolescence is likely to help protect against later heart disease, particularly if people stay fit as they age. Physical activity may also alleviate some of the negative consequences of stress. This is relevant to all adolescents, but those with poorer wellbeing could benefit from additional support to encourage exercise and to develop strategies to deal with stress,” recommends Dr Bergh.