Premature cardiovascular disease (CVD) and poor CV health (CVH) in young adults living in the United States (US) are associated with depression and poor mental health. These findings were published in the Journal of the American Heart Association.

Investigators from Johns Hopkins University School of Medicine sourced data for this study from the Behavioral Risk Factor Surveillance System (BRFSS) which collected nationally representative data between 2017 and 2020 in the US. Adults (N=593,616) aged 18 to 49 years were evaluated for the relationship between CVH and mental health. Suboptimal CVH was defined as the presence of 2 or more of 7 CVD risk factors, including history of diabetes, hypercholesterolemia, hypertension, inadequate fruit and vegetable intake, being overweight/having obesity, physical inactivity, and being a current smoker.

The study cohort comprised 50.3% men, 23.3% were aged 18 to 24 years, 54.1% were White, 28.4% were college graduates, 71.0% were employed, 94.4% lived in an urban area, 65.1% lived at over 200% of the federal poverty line, and 82.5% had some health insurance coverage.

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A total of 16,273 individuals had CVD and, compared with patients without CVD, all demographic characteristics differed significantly (all P ≤.007) except for gender.

Overall, the rate of depression was higher among individuals with CVD (43.7% vs 16.0%; P <.001) and CVD and depression were correlated (r, 0.22). Prevalence of depression and CVD together were highest in West Virginia (depression: 29.74%; CVD: 4.71%) and lowest in Hawaii (depression: 13.07%; CVD: 1.07%).

In the fully adjusted model, risk for CVD was associated with depression (adjusted odds ratio [aOR], 2.32; 95% CI, 2.13-2.51) and 1 to 13 (aOR, 1.48; 95% CI, 1.34-1.62) or 14 to 30 (aOR, 2.29; 95% CI, 2.08-2.51) poor monthly mental health days compared with 0 days. Similar trends were observed for the outcome of suboptimal CVH associated with depression (aOR, 1.77) and poor mental health days (aOR range, 1.23-1.82).

No significant interactions were observed for the relationship between depression and CVD for gender or rurality of residence.

These findings may be limited by the fact that outcomes were self-reported.

“Depression and poor mental health are associated with premature CVD and suboptimal CVH among young adults,” the study authors wrote. “Although this association is likely bidirectional, prioritizing mental health may help reduce CVD risk and improve CVH in young adults.”

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Kwapong YA, Boakye E, Khan SS, et al. Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United StatesJ Am Heart Assoc. Published online January 23, 2023. doi:10.1161/JAHA.122.028332

This article originally appeared on The Cardiology Advisor