Patients who have had a blood clot in the heart are at increased risk of dying or developing a new cardiovascular event if they are also in poor mental health. This was shown by a recent registry study from Aarhus University.

2013.09.25 | Lone Niedziella

A recent registry study from MEPRICA demonstrates that poor mental health increases the risk of new heart attacks.

Every second patient who has had a blood clot in the heart and who is also in poor mental health dies or has another cardiovascular event within three years, whereas this is only the case for one in every seven patients in good mental health.

This was established by a recent registry study from the research project Mental Health in Primary Care (MEPRICA) at Aarhus University. The study was published in the online journal BMJ Open.

The increased risk may, in part, be explained by differences in the degree of severity of the heart disease, but physical activity and depression and anxiety symptoms also seem to play a role. But even when researchers take these factors into account, heart patients who are in poor mental health have twice the risk of dying or experiencing another cardiovascular event compared with heart patients in good mental health. 

A combination of factors

The causes of this association remain unknown. Part of the explanation may be that mentally ill persons do not receive the same treatment options as stronger patients do, that self-care is inadequate among persons of poor mental health or that the genetic make-up of this group leaves them at a disadvantage.

“The difference is probably due to a combination of several different causes, and future studies should investigate what we can do to improve the prognosis for heart patients in poor mental health,” says Research Assistant Tine Jepsen Nielsen, Aarhus University.

Read the article "Mental health status and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based cohort study."

Facts:

• The study is based on patients from the Central Denmark Region who had blood clots in the heart in 2009.
• Data from 880 patients were included in the study.
• Mental health was measured using the SF-12 Health Survey questionnaire. The questionnaire is used to measure the patient’s mental health status, a broad measure of mental health. In addition to the patient’s mental well-being, the questionnaire also measures the influence of mental health on everyday life and social life.
• Mental health was measured about three months after the patients had been discharged from hospital.
• Patients were followed for about three years, during which period the researchers recorded deaths and new cardiovascular episodes (new blot clot in the heart, stroke or heart failure).

 Further information:

Research Assistant Tine Jepsen Nielsen
MEPRICA and the Research Unit for General Practice
Aarhus University, Department of Public Health 
Tel: 2160 3470
E-mail: tjn@folkesundhed.au.dk

Doctor, PhD Karen Kjær Larsen
MEPRICA and Section for General Medical Practice
Aarhus University, Department of Public Health
Tel: 2089 9503
E-mail: kkl@alm.au.dk