Depressed Young People are at Risk for Heart Disease

Chronic inflammation may explain why some teens who are depressed or bipolar have hardened arteries and other signs of heart disease. Here's what you should know.

Heart disease is the leading cause of death for both men and women in the U.S., according to the Centers for Disease Control and Prevention (CDC). Although middle-aged and older people are more at risk of a heart attack or stroke, their troubles may arise much earlier. Your state of mind in your teens or even younger may make a difference.

Mental stress takes a toll. For example, in a study of nearly 420,000 men evaluated at age 18 or 19 for military service in Sweden, signs of depression or anxiety were linked to heart disease as they grew older. In fact, the troubled teens had a 20 percent higher chance of a heart attack by age 58.

That was true even after taking into account their blood pressure, body mass index, general health, and parents’ socioeconomic status.

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Coaching to help young people manage stress and stay fit through exercise is a remedy, researchers said.

In other research, with adults younger than middle-age — more than 18,700 Americans age 18 to 29 included in a larger group up to age 49 — researchers reported that depression more than doubled the odds of cardiovascular disease (CVD).

The link between heart disease and depression has been observed even in children. A study of 77 patients in a pediatric depression program found that 46 percent had a family history of early CVD.

A quarter of them had high blood pressure, and 28 percent had high total cholesterol. More than half of the participants had at least two CVD risk factors.

The researchers recommended screening depressed children routinely for CVD, even if they aren’t overweight.

One problem is that young people, even more than other Americans, eat junk food, putting their hearts at risk. They also don’t exercise enough. In one study, only 14 percent of 11- to-19-year-olds had high marks in a scoring system that included diet, physical activity, and body mass index.

In a classic bad loop, a poor diet and lack of exercise aggravate low mood, and low mood leads to more inactivity and snacking or binging.

An American Heart Association (AHA) committee of medical experts analyzed published studies of heart attacks and deaths among young people. They found that teens with major depression or bipolar disorder are more likely than other youngsters to have many cardiovascular disease risk factors, including hardening of the arteries. 

It’s well known that people with depression are more likely to suffer from heart disease (and vice versa). But doctors and parents may not be thinking about CVD in the young and taking action, the report concluded.

Mental health is a problem for many American teens. The latest pre-pandemic figures from the CDC report that, among adolescents aged 12- to 17 years:

• More than 15 percent had a major depressive episode
• Nearly 37 percent had persistent feelings of sadness or hopelessness
• Nearly 19 percent seriously considered attempting suicide
• Nine percent made an attempt

Exactly why mood disorders are associated with CVD remains unknown. The AHA panel did note that inflammation and other types of cell damage, which some studies have found are more common in teens with mood disorders, may play a role.

The AHA report also pointed out that young people with mood disorders are more likely than other teens to abuse drugs, smoke, and avoid exercise.

Yet, those factors aren’t enough to explain why depressed and bipolar youngsters are more likely to develop cardiovascular problems, according to the AHA analysis.

Prescription drugs to treat mood disorders in teens also didn’t fully explain the risk. Some medications increase blood pressure and can cause weight gain, higher levels of cholesterol, and blood sugar levels, but most teens in the studies analyzed for the AHA report were not taking them.

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