The findings of researchers Eco de Geus, Jorien Treur and Brenda Penninx from Vrije Universiteit Amsterdam and Amsterdam UMC have been published in Nature Cardiovascular Research under the title Genetic perspectives on the co-morbidity of anxiety and mood disorders with cardiovascular disease. The insights may contribute to improved collaboration between mental healthcare and cardiology.
Three factors behind the association
Anxiety and mood disorders, such as depression, are remarkably common among people with cardiovascular disease. To better understand why these conditions frequently occur together, researchers analyzed a large body of genetic and epidemiological studies.
Their findings show that the association between depression and cardiovascular disease can be explained by three factors:
- Shared genetic predisposition: certain genetic factors increase the risk of both mental and physical disorders.
- Shared environmental influences: factors such as low socioeconomic status, chronic stress, and adverse living conditions contribute to both conditions.
- A direct effect of depression on cardiovascular disease: people with depression appear to have an increased risk of developing cardiovascular disease.
No evidence for the reverse relationship
The researchers drew on evidence from the Netherlands Twin Register (NTR), other twin studies, and large-scale genetic analyses investigating DNA variation. These genetically informative study designs make it possible to distinguish causal relationships from associations that arise through shared genetic or environmental factors.
The results suggest that anxiety and mood disorders can increase the risk of cardiovascular disease. In contrast, the researchers found no convincing evidence for the reverse relationship—that cardiovascular disease leads to the development of mental disorders.
Evidence from randomized treatment studies supports this conclusion. Treatment of depression has been shown to have beneficial effects on cardiovascular health, whereas treatment of cardiovascular disease does not consistently lead to improvements in mental health.
Major implications for healthcare
According to the researchers, the findings underline the importance of an integrated approach to mental and physical health. In clinical practice, these conditions are still often treated separately, despite the fact that many of their risk factors overlap.
An integrated care approach, involving collaboration between psychiatrists, psychologists, general practitioners, and cardiologists, may better support patients. Interventions aimed at stress reduction, lifestyle improvement, and prevention appear particularly promising in reducing the combined burden of mental and physical health problems.
Societal impact
The findings are relevant for a growing group of patients living with multiple conditions. Earlier recognition and treatment of mental health problems may also help reduce the risk of serious cardiovascular disease.
The researchers therefore call for greater attention to the interaction between mental and physical health. Improved collaboration between medical disciplines could not only enhance patients’ quality of life, but also help reduce the societal and economic burden of chronic disease.
Link to publication:Genetic perspectives on the comorbidity of anxiety and mood disorders with cardiovascular disease | Nature Cardiovascular Research
Source: VU.nl