| Title: | Mental health status and cardiovascular outcomes across Life's Essential 8 categories |
| Journal: | International Journal of Cardiology Cardiovascular Risk and Prevention |
| Published: | 14 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41362634/ |
| DOI: | https://doi.org/10.1016/j.ijcrp.2025.200545 |
Publication 16806
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Abstract
Background: Anxiety and depression are established risk factors for cardiovascular disease (CVD); impacts of these conditions on cardiovascular outcomes across different levels of cardiovascular health (CVH), measured by Life's Essential 8 (LE8) scores, remain unclear.</p>
Methods and results: We analyzed 290,778 UK Biobank participants (mean age 56.5, 56.1 % male) without prior CVD. CVH was assessed using the LE8 score. Mental health status (healthy, anxiety only, depression only, or comorbid anxiety and depression) was determined through PHQ-4 items and ICD-10 codes (F32-F33 for depression, F40-F41 for anxiety). Cardiovascular outcomes were defined as a composite of coronary heart disease (CHD), heart failure (HF), and stroke. Cox proportional hazards models were adjusted for confounders and stratified by LE8 score (<50 [poor CVH] vs. ≥50 [intermediate-optimal]). Compared to the mentally healthy group, participants with comorbid anxiety and depression had the highest overall cardiovascular risk (adjusted HR 1.85 [95 % CI 1.74-1.97]). The impact of mental health status varied according to baseline LE8 scores. Among those with LE8 <50, isolated anxiety (adjusted HR 1.23 [1.09-1.40]), depression (adjusted HR 1.34 [1.22-1.47]), as well as comorbid anxiety and depression (adjusted HR 1.46 [1.31-1.64]) were all associated with increased cardiovascular risk. In the LE8 ≥50 group, isolated anxiety (adjusted HR 1.39 [1.30-1.48]), isolated depression (adjusted HR 1.52 [1.43-1.60]), and comorbid anxiety and depression (adjusted HR 1.78 [1.66-1.90]) were all associated with increased risk.</p>
Conclusions: Mental health independently affects cardiovascular risk, modified by baseline CVH. Mental health emerge as a relative risk predictor among individuals with CVH (LE8 ≥ 50).</p>
10 Authors
- Enze Li
- Le Zhou
- Liu He
- Song Zuo
- Song-Nan Li
- Xiao-Xia Liu
- Cai-Hua Sang
- Jian-Zeng Dong
- Xue-Yuan Guo
- Changsheng Ma
Enabling scientific discoveries that improve human health