Depression: A Surprising Risk Factor for Heart Disease

Alan Reisinger, Author
By A. Alan Reisinger, III, MD, FACP
January 31, 2022

You may not realize it, but your mental health can heavily influence your risk for heart disease. From stress to anxiety to depression, how your feeling can affect your heart's health. Learn more in this video from Dr. Alan Reisinger.


I’m sure you know that things like smoking, what you eat and your family history can influence your risk for heart disease. But did you know that your mental health — from stress to anxiety to depression — can also increase your risk for heart attack and stroke?

This may be surprising, but it’s unfortunately true.

There are some obvious reasons why these three conditions can hurt your heart. When we’re stressed, anxious or depressed, we don’t always make the right decisions. We may embrace bad habits like eating too much or drinking too much or doing drugs. Or our emotional state may cause us to miss sleep, which can take a huge toll on our overall health.

But there are other reasons that stress, anxiety and depression affect our heart negatively.

Let’s talk about stress first. When we feel stressed, it can cause a chain reaction in our bodies. Your body releases adrenaline, a hormone that prepares your body for fight or flight. Adrenaline temporarily increases your heart rate and blood pressure. It also causes your breathing to speed up.

Stress also causes your body to release cortisol, another hormone. Studies show that high levels of cortisol over time can increase your cholesterol, triglycerides, blood sugar and blood pressure levels. None of this is good for your heart.

What about anxiety? You may think of anxiety and stress as the same thing. And they’re very closely related. Stress is usually triggered by an external factor – a deadline at work, a fight with a loved one or driving in traffic. It’s usually short term.

Anxiety, however, is persistent. It happens even when there’s not a triggering event or stressor. Think of this as the culmination of all our worries – real or perceived. Like stress, anxiety can cause your breathing and heart rate to increase. In addition to an increased heart rate, anxiety can cause palpitations and chest pain. And it generally causes your blood pressure to rise.

Our heart is equipped to handle these responses to stress and anxiety over the short term. But as stress and anxiety become chronic, they have a greater impact on our heart’s health.

While the relationship between stress and anxiety and heart disease is well known, the link between depression and heart disease is not. It appears the two diseases are linked. People with heart disease are twice as likely to have depression. And people with depression have a substantially increased risk of heart disease.

There’s good evidence that depression can develop after stroke or heart attack. Loss of mobility, worry, stress and fear after a cardiac event can lead to depression.

But people with depression have a 64 percent greater risk of developing heart disease than people without depression. Why? We’re not sure, but here’s an educated guess:

  • People with depression may also experience chronic stress and anxiety.
  • They may also have difficulties coping with their mental health challenges, which can make it more difficult for them to make healthy lifestyle choices that reduce their heart disease risk.
  • People with depression may get less exercise or may drink or smoke. They may eat more and sleep less.

Even though we’re not 100 percent sure why there’s a connection, it’s important if you suffer from depression to talk to your doctor about heart disease. Treating your depression can help lower your risk of heart problems.

Whether you’re experiencing stress, anxiety or depression, your MDVIP-affiliated physician is equipped to help you — but not if they don’t know about it.

Next time you talk to your doctor, be sure to share how you’re feeling. While everyone deals with a little bit of stress, anxiety or sadness, chronic stress, anxiety or depression are killers – especially for your heart.

About the Author
Alan Reisinger, Author
A. Alan Reisinger, III, MD, FACP

Dr. Reisinger is MDVIP’s Associate Medical Director. He practiced for 35+ years as a board-certified internal medicine specialist with a heart for people, a focus on prevention and a desire to see primary care delivered the way it was intended. Serving as a member and subsequent chairman of MDVIP’s medical advisory board, he has helped to lead the clinical direction of the organization since 2008 and has been a passionate advocate for aggressive cardiovascular prevention in our network.

Previously, Dr. Reisinger was on the medical advisory board for Cleveland HeartLab and currently is a member of the BaleDoneen Academy, a Fellow of the American College of Physicians, a member of the American Society for Preventive Cardiology and an advisory board member of the American Academy for Oral Systemic Health.

Integral to his calling is his commitment to improving patient care, and he is resolute in the need to foster enhanced collaboration between the medical and dental communities. He has lectured nationally on cardiovascular disease prevention. Dr. Reisinger has embraced the mission of changing the outcome of CVD, the leading cause of death in the world… “because we can.”

View All Posts By A. Alan Reisinger, III, MD, FACP
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