Stress test in the doctor’s office could estimate your heart risk

By Cara Murez

health day reporter

WEDNESDAY, November 9, 2022 (HealthDay News) — Assessing a person’s psychological stress may be a good way to gauge their risk of heart and blood vessel disease, new research suggests.

And a short questionnaire could help with the assessment, the study results showed.

“Our study is part of the growing evidence that mental distress is a really important factor in a cardiovascular diagnosis, along with other health behaviors and risk factors like physical activity and cholesterol levels that clinicians monitor,” said co-author Emily Gathright. She is an Assistant Professor of Psychiatry and Human Behavior at Warren Alpert Medical School at Brown University in Providence, RI

For the study, the team examined research published in the past five years that involved adults without a psychiatric diagnosis, who were evaluated for depression, anxiety, post-traumatic stress disorder, stress, or general mental health symptoms and followed for more than six months. About 58% were women.

Overall, Gathright and her colleagues analyzed the results of 28 studies involving more than 658,000 patients. The researchers found that those who reported high levels of mental distress had a 28% greater risk of heart disease.

According to study co-author Carly Goldstein, assistant professor of psychiatry and human behavior, a brief mental health questionnaire can give physicians not only a better idea of ​​a patient’s mental health risks, but also the associated risk for mental health heart diseases.

Based on the results of the questionnaire, the doctor can immediately advise the patient on how improving their mental health can help them improve their heart health, she added.

“This analysis shows that a patient’s psychological distress is directly related to their cardiovascular risk, which offers clinicians opportunities to help a patient manage their risks over time to improve overall health right at the point of care,” Goldstein said in a Brown University press release.

Before the study, it was not known whether brief mental health screening would help predict heart disease risk, she noted.

Most research examining the links between mental health and heart disease has focused on people who have already been diagnosed, said study co-author Allison Gaffey, a clinical psychologist at the Yale School of Medicine in New York Haven, Connecticut, who did her pre-internship at Brown’s Medical School.

“Certainly we know that mental health is important within the framework of care management,” Gaffey said.

The screeners used in the studies were short and well known, and could be administered with confidence by any clinical provider, she noted.

“We believe that using these short screeners, whether in a hospital setting or a community health care setting, provides feedback that is helpful in understanding cardiovascular disease risk in a very multidimensional way compared to using Standard assessments such as blood pressure or cholesterol levels. ‘ Gaffey said.

Even without meeting the criteria for high psychological distress, patients who have any distress could still benefit from additional support to prevent heart disease, she added.

Researchers noted that while the updated American Heart Association guidelines added “healthy sleep” as an essential aspect of good heart health, they did not add “stress management and mental health.”

This checklist should be expanded to include good mental health, the team suggested.

Depression was the most common aspect of mental distress measured in the studies analyzed, Goldstein said, noting that screening should also attempt to measure anxiety.

“I would encourage all providers, cardiovascular and specialty providers, as well as general practitioners, to do some sort of brief mental stress screening to assess cardiovascular risk,” she advised. “And I would argue that any provider’s practice can make brief recommendations to patients who justify it, which can be as simple as pointing out free, publicly available mental health resources.”

Mental health support recommendations can also make a difference in the patient’s overall health, Goldstein said.

The results were published on November 7th in the Journal of Cardiopulmonary Rehabilitation and Prevention.

More information

The World Health Organization has more on heart and blood vessel disease.

SOURCE: Brown University, press release, November 7, 2022