If you're younger or middle-aged and have a heart attack, your mental health may affect your long-term survival, a new study suggests. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You Had COVID and Didn't Know It.

Patients in High Distress Have Greater Risk

Researchers at Emory University looked at 283 heart attack survivors aged 18 to 61 (average age 51). Each answered questionnaires assessing their levels of depression, anxiety, anger, stress, and post-traumatic stress disorder (PTSD) within six months of their heart attack. Using that data, the scientists categorized each person as having mild, moderate, or high mental distress.

Within five years after their heart attack, 80 of the 283 patients had an additional heart attack or a stroke, were hospitalized for heart failure, or died from heart-related causes. The researchers found this happened in 47% of patients with high distress, compared to 22% for those with mild distress. 

The findings are scheduled to be presented on May 16 at the American College of Cardiology (ACC)'s virtual annual meeting. They have not yet been peer-reviewed.

"Our findings suggest that cardiologists should consider the value of regular psychological assessments, especially among younger patients," said lead author Dr. Mariana Garcia, a cardiology fellow at Emory University, in a statement.

"Equally importantly, they should explore treatment modalities for ameliorating psychological distress in young patients after a heart attack, such as meditation, relaxation techniques, and holistic approaches, in addition to traditional medical therapy and cardiac rehabilitation," said Garcia.

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Mental Health Affects Heart Health

The researchers say their study is the first to assess mental health affects recovery for younger heart attack survivors. However, their findings are similar to previous studies focusing on older adults, which found that mental health is a key factor in heart attack recovery.

The study also adds to a wealth of research that suggests mental health affects heart health—conditions such as anxiety, depression, and PTSD can cause a stress response which can contribute to inflammation, a risk factor for cardiovascular disease. The researchers also found that heart attack patients reporting high distress were more likely to be Black, female, poor, users of tobacco, and to have diabetes or high blood pressure.

"This finding highlights the importance of socioeconomic status in regard to higher distress and raises important questions about the role of race, sex, and other factors," said Garcia.

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How Stress Taxes the Heart

"When stress is excessive, it can contribute to everything from high blood pressure, also called hypertension, to asthma to ulcers to irritable bowel syndrome," said Ernesto L. Schiffrin, M.D., Ph.D., professor in the Department of Medicine at McGill University, who was not involved in the study. Hypertension damages blood vessels, which can lead to heart attack or stroke, and stress can cause people to engage in unhealthy behaviors like binge drinking and overeating.

Experts advise dealing with stress by exercising, avoiding tobacco, drinking only in moderation, eating a healthy diet and maintaining a healthy weight—all of which have been shown to reduce the risk of heart disease. So stay safe, get vaccinated when it becomes available to you, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.