Stress may help explain why patients with depression are at higher risk of cardiovascular disease

By Admin

18 Dec, 2025

Depression has long been linked to an increased risk of cardiovascular disease, but the biological reasons behind this connection are still being uncovered. A new study from Mass General Brigham provides important insights, suggesting that stress-related brain activity, nervous system imbalance, and chronic inflammation may play a key role in explaining why patients with depression are more vulnerable to heart disease.

Depression, Anxiety, and Heart Disease Risk

The research analyzed data from 85,551 participants enrolled in the Mass General Brigham Biobank. Among them, 14,934 individuals had both depression and anxiety, 15,819 had either depression or anxiety, and 54,798 had neither condition. Over a median follow-up period of 3.4 years, 3,078 participants experienced major adverse cardiovascular events, including heart attacks, heart failure, or stroke.

The findings showed that both depression and anxiety were associated with a higher risk of cardiovascular disease. Notably, individuals diagnosed with both conditions faced about a 32% higher risk compared to those diagnosed with only one. These associations remained strong even after accounting for lifestyle habits, socioeconomic factors, and traditional cardiovascular risk factors such as smoking, diabetes, and hypertension.

The Role of Stress in the Brain and Body

To better understand the biological link, researchers examined advanced brain imaging and biomarkers related to nervous system activity and inflammation in a subset of participants. People with depression or anxiety showed increased activity in the amygdala, a brain region closely involved in processing stress and fear. They also had reduced heart rate variability, indicating an overactive nervous system, along with higher blood levels of C-reactive protein (CRP), a marker of chronic inflammation.

Together, these findings suggest a biological chain reaction. Overactive stress circuits in the brain can chronically stimulate the body’s “fight or flight” response, leading to sustained increases in heart rate and blood pressure, along with ongoing inflammation. Over time, these processes can damage blood vessels and accelerate the development of cardiovascular disease.

Why Emotional Health Matters for the Heart

The study reinforces the idea that protecting heart health goes beyond managing diet, exercise, and cholesterol levels. Emotional and mental health play a critical role as well. Chronic stress, depression, and anxiety may silently strain the cardiovascular system, even when other risk factors are well controlled.

Future Directions and Prevention Strategies

Since the study was observational, it cannot confirm that depression and anxiety directly cause cardiovascular disease. However, the strong associations highlight the need for further research. Scientists are now exploring whether interventions such as stress-reduction therapies, lifestyle changes, or anti-inflammatory treatments can help normalize stress-related brain activity and immune responses, potentially lowering heart disease risk.

These findings suggest that integrating mental health care into cardiovascular prevention strategies may be a powerful step toward reducing the burden of heart disease in patients with depression and anxiety.