Leela Magavi, M.D. discusses why high cardiovascular risk may be associated with symptoms of depression.

man looking depressed with hand on head, leaning against house window

A new study reports that cardiovascular risk factors are associated with an increased risk of depression in older adults.

Although it’s been previously shown depression could be a risk factor for developing cardiovascular disease, studies analyzing the potential impact of cardiovascular health on developing depression are scarce.

The two conditions are thought to have similar risk factors, such as inflammation and oxidative stress.

In their study, Sandra Martín-Peláez, Ph.D., a biologist at the University of Granada, Spain, and her team used data from an ongoing six-year multi-center randomized trial in Spain that analyzed the effect of a Mediterranean diet on obese or overweight men aged 55 to 75 and women aged 60 to 75.

The researchers focused on 6,545 people with no cardiovascular or endocrine disease at baseline, but who still could be divided into risk groups. The participants’ mental health status was gauged using a questionnaire, then followed up for two years.

After two years of subjects following a Mediterranean diet, participants on average decreased their depressive status score. The greatest decreases were seen in medium-risk and high-risk participants with high baseline cholesterol levels.

The connection

The study authors concluded that high cardiovascular risk is associated with depressive symptoms, especially in women, and that factors such as adhering to the Mediterranean diet deserve further research.

“What was particularly revealing from the study was that those individuals at higher cardiovascular risk who followed the Mediterranean diet saw greater decreases in their depressive symptoms,” Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California, told Healthline. “While we know that a healthy diet is effective in improving emotional health, this study helps quantify how much.”

“The physical connection between cardiovascular disease and depression likely has to do with oxidative stress, inflammatory burden, and disruption of bodily processes,” Tadwalkar added. “These changes in homeostasis are seen in cardiovascular disease, which can then go on to affect other organs and systems, including the brain and its pathways.”

“This study also shows us a great example of how the adage ‘food is medicine’ rings true,” Tadwalkar said. “Rigorous study has demonstrated that the Mediterranean diet can decrease inflammatory burden, body mass index, bad cholesterol levels, along with a variety of other metabolic parameters. The resulting impact on the body is positive, including in both physical and psychological health.”

Sydney B. Miller, Ph.D., a Canadian psychologist, told Healthline the study shows the effect depression and a bad diet can have on one another.

He noted the relationship can be “modifiable.”

“One explanation for this relationship may be that plasma cholesterol levels taken from a bold sample may reflect brain cholesterol concentrations, and those may affect central nervous functioning, including depression,” Miller said.

“This study suggests that if you have the cardiovascular risk factor of high cholesterol, that increases your risk for depression,” he said. “We already know that depression increases your risk for heart disease so what we have here is what is called a bi-directional relationship. It does appear that one helps cause the other.”

“One note of caution, however, is that though other studies have found the high cholesterol causes depression, other studies have reported that low cholesterol causes depression, and still other studies have found no relationship between the two,” Miller said. “So, whereas this study is exciting, it would be nice to see the results replicated in future studies.”

Making choices

Dr. Kush Agrawal, a cardiologist with Honor Health Hospitals in Scottsdale, Arizona, told Healthline not only does stress and depression promote inflammation, but it also leads to poor lifestyle choices, making the physical situation even worse.

“It is also thought that depression leads to non-adherence to medical regimens and self-care lifestyles, resulting in less time spent exercising, poorer sleep quality and quantity, less restriction of caloric excess and unhealthy foods and diets, and less compliance with prescription medications for chronic diseases such as hypertension, high cholesterol, and diabetes,” Agrawal explained.

“Psychological stress, whether it is work/finance or home-related, seems to also be an independent risk factor for new-onset myocardial infarction or heart attacks,” he added.

Dr. Leela R. Magavi, a psychiatrist and regional medical director for Mindpath Health, told Healthline there are numerous ways to fight the stress that can affect cardiovascular systems.

“Creating lists and reiterating the things that are in our control could alleviate anxiety,” Magavi said. “Taking breaks from reading about COVID-19 or watching the news and instead spending time exercising and practicing mindfulness techniques could help individuals decrease ruminative thinking.”

Magavi recommended meditation or consulting with a therapist, as well as simple home-based remedies.

“Conversing with family or journaling about fears could help individuals process their emotions and begin the healing process,” she said. “Reaching out to a friend, colleague, neighbor, primary care physician, therapist, or psychiatrist could help initiate the healing process and save priceless lives.”

To read the full article with sources on Healthline and learn more about how high cardiovascular risk can be associated with symptoms of depression, click here. 

Leela R Magavi, M.D.

Newport Beach, CA

Dr. Leela Magavi is a native Californian and Hopkins-trained psychiatrist committed to providing compassionate, evidence-based care to individuals of all cultural, political, religious, sexual, and socioeconomic backgrounds. She completed her adult psychiatry residency at Georgetown University Hospital, during which time she also had the invaluable experience of caring for veterans at Washington, D.C. VA. As a resident, she was awarded ... Read Full Bio »

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