Highlights:
- Persistent psychological distress up to 12 months post-heart attack can raise risk of recurrence by nearly 1.3 times.
- Between one-third and half of survivors experience depression, anxiety or PTSD.
- Interventions such as cognitive behavioural therapy, medication and stress-reduction can improve recovery and quality of life.
Psychological distress and heart health
Persistent psychological distress following a heart attack could increase the risk of another cardiac event by nearly 1.3 times, researchers have found.
A review by the American Heart Association (AHA) reported that 33–50 per cent of heart attack survivors suffer symptoms such as depression, anxiety or post-traumatic stress disorder (PTSD). These mental health issues, the researchers said, can significantly affect both physical recovery and long-term health outcomes.
Findings from the review
The team analysed previous studies on myocardial infarction, acute coronary syndrome, depression, stress and PTSD.
“After a mean follow-up of 4.7 years, moderate psychological distress was associated with a 28 per cent increased risk of future myocardial infarction, while high or very high distress was linked to a 60 per cent increase compared with low distress,” the authors wrote in the journal Circulation.
Professor Glenn N Levine of Baylor College of Medicine, who chaired the writing group, said psychological distress was often overlooked. “We often focus on the physical aspects of heart disease, yet psychological health is linked to physical health, so when a major cardiac event like a heart attack occurs, emotional recovery is just as important,” he noted.
Why mental distress matters
The researchers explained that damage to the heart muscle can trigger inflammation, hormonal changes and chemical shifts in the brain that contribute to depression, anxiety or PTSD. Acute stress may also narrow coronary arteries, reduce blood flow and cause irregular rhythms, even in people without prior heart disease.
Lifestyle factors linked with psychological distress – such as reduced physical activity, smoking, alcohol use, poor diet, disturbed sleep, weak social support and low medication adherence – can further increase the risk of a recurrent cardiac event. A history of chronic illness or mental health conditions adds to this vulnerability.
Scope of the problem
According to the AHA, anxiety and stress may affect up to 50 per cent of heart attack patients during hospitalisation, and continue in 20–30 per cent of cases for months after discharge.
The authors stressed that while more research is required to confirm a direct causal link, the association is clear: “Up to half of patients after myocardial infarction may experience psychological distress, and this has been associated with a higher risk of future cardiac events.”
Addressing psychological recovery
Experts recommend interventions including cognitive behavioural therapy, antidepressants and stress-reduction techniques. These can help reduce distress, improve emotional wellbeing, and enhance quality of life for heart attack survivors.
