How Mental Health Can Affect Cardiovascular Disease – Positively and Negatively

Woman has chest pain
Should cardiologists be looking at patients’ mental health as well as their physical health? Research has suggested that a patient’s mental health disorder and outlook may play a role in cardiovascular health. What are the different ways mental health affects cardiovascular disease?

As May is Mental Health Awareness Month, it is important to think of how mental health care can not only affect a patient’s mood and emotional state, but their physical health as well.

If you’re assessing patients holistically, you’ll want to examine theircardiovascular health, as there are so many associated risk factors and comorbidities. Cardiology specialists should discuss any potential heart issues with their patients who have mental health issues or disorders. How might mental health struggles adversely affect a patient’s cardiovascular health, and can improving mental health help improve cardiovascular functionality?

How Can Mental Health Negatively Affect Cardiovascular Health?

According to the US Centers for Disease Control and Prevention (CDC), many mental health disorders may have cardiologically-related physiologic effects on the body.¹ Depression, anxiety, and post-traumatic stress disorder (PTSD) have been associated with increased blood pressure and heart rate, as well as a reduction in blood flow to the heart. 

Some of this can be attributed to the increased adrenaline and cortisol that stress generates in the body.² However, these mental health disorders can also manifest after a patient has a cardiovascular event like heart disease or a stroke. Often, these patients are still processing the trauma of their event, experiencing fear of death or another attack, and they may also be worried about the cost of their treatment.

Mental health disorders can also make people more likely to engage in behaviors known to be detrimental to cardiovascular health, like smoking and excessive alcohol consumption. In addition, depressed patients may be less likely to exercise and make healthy lifestyle choices.

How Can Mental Health Positively Affect Cardiovascular Health?

In early 2021, the American Heart Association published a statement in Circulation stressing the importance of boosting patients’ psychological health and well-being as a way of improving their cardiovascular health.³ The study researchers claim that, “positive psychological factors are independently associated with cardiovascular benefits beyond simply the absence of negative states.” 

These positive factors include optimism, sense of purpose, mindfulness, and life satisfaction. The research findings suggest that cardiologists should be aware of their patients’ mental state and actively work to get them the proper treatment upon presentation of any mental distress or decline.

While patients experiencing mental health issues may not feel satisfied or capable of optimism, treatments like behavioral counseling can introduce tools and concepts that allow individuals to manage their struggles. 

A 2020 study in JAMA Network Open examined how behavioral counseling, care coordination, and care management could affect the cardiovascular health of patients who have a serious mental illness and at least 1 cardiovascular risk factor.⁴ The trial participants who were in the intervention group and received this treatment for 18 months showed a 12.7% reduction in the probability of a cardiac event over the next 10 years.


1. US Centers for Disease Control and Prevention. Heart disease and mental health disorders. Reviewed May 6, 2020. Accessed May 12, 2021.

2. American Heart Association. Mental health and heart health. Reviewed April 18, 2018. Accessed May 12, 2021.

3. Levine GN, Cohen BE, Commodore-Mensah Y et al. Psychological health, well-being, and the mind-heart-body connection: a scientific statement from the American Heart Association. Circulation. 2021;143(10). doi:10.1161/cir.0000000000000947

4. Daumit GL, Dalcin AT, Dickerson FB, et al. Effect of a comprehensive cardiovascular risk reduction intervention in persons with serious mental illness: a randomized clinical trial. JAMA Netw Open. 2020;3(6):e207247. doi:10.1001/jamanetworkopen.2020.7247