Recognising and treating psychological distress with strategies such as cognitive behavioural therapy, antidepressants and stress reduction techniques could help improve mental health.
Persistent psychological distress following a heart attack event and lasting up to 12 months could increase the risk of another cardiac event by nearly 1.3 times, according to a study.
Recognising and treating psychological distress with strategies such as cognitive behavioural therapy, antidepressants and stress reduction techniques could help improve mental health, emotional well-being and quality of life for survivors, researchers said.
The team from the American Heart Association said about 33-50 per cent of heart attack survivors are estimated to suffer psychological symptoms, including depression, anxiety or post-traumatic stress disorder (PTSD), all of which can affect physical recovery and long-term health.
The researchers reviewed previously published research on myocardial infarction, acute coronary syndrome, depression, anxiety, stress and PTSD, among others.
“After a mean of 4.7 years of follow-up, moderate psychological distress was associated with a 28 per cent increased risk of future (myocardial infarction) and high (or) very high distress was associated with a 60 per cent increased risk compared with low distress,” the authors wrote in the review published in the journal Circulation.
Author and chair of the group writing the article, Glenn N Levine, said, “Psychological distress after a heart attack is quite common but often goes unrecognised.” “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,” Levine, a professor of medicine at Baylor College of Medicine, USA, said.
The researchers explained that damage to heart muscle due to a heart attack can trigger inflammation, causing hormonal shifts and chemical changes in the brain that may contribute towards symptoms of depression, anxiety or PTSD.
Acute psychological stress can narrow the heart’s arteries (coronary vasoconstriction), reduce blood flow to the heart (ischaemia) and cause irregular heart rhythms (arrhythmia), even in people without previous heart issues, the team said.
They added that factors through which psychological distress can increase risk of a recurrence of cardiac attack include lesser physical activity, smoking and alcohol, poor diet and sleep, inadequate social support and a lower medication adherence.
Having a history of mental health conditions or chronic illness too can add to the risk, the team said.
Anxiety and stress may affect up to 50 per cent of heart attack survivors during hospitalisation and persist in 20-30 per cent of people for several months or more after hospital discharge, they added.
The authors said that more research is needed to confirm a direct cause-and-effect relationship between psychological distress following a cardiac event and a recurrence of a heart attack.
