Several mental illnesses, notably posttraumatic stress disorder (PTSD) and sleep disorders, increase the risk of heart attacks and unstable angina, according to a meta-analysis published by JAMA Psychiatry today.Why It’s Relevant
Numerous research studies have found an association between poor mental health and poor cardiovascular health, likely mediated by genetic links, increased inflammation, exaggerated responses to stressors, illness-driven behaviors, and/or psychiatric medications.
Yet there have been few systematic efforts to examine the comparative risk of different mental illnesses for acute coronary syndrome (ACS)—a medical emergency whereby blood flow to the heart muscle suddenly drops. Understanding the risks and mechanisms at play can guide targeted interventions.
By the Numbers
- Among a sample of more than 22 million individuals pooled from 25 observational or randomized studies, 12.9% were diagnosed with a mental disorder at baseline, and 1.4% fulfilled criteria for an incident ACS event.
- The most significant risk factor identified was PTSD, which was linked with nearly three times higher risk of ACS and supported by moderate quality evidence.
- Depressive, anxiety, and sleep disorders were also associated with an increased risk of ACS.
- Bipolar disorders and psychotic disorders were not associated with increased risk of ACS.
The Other Side
Although the results for bipolar and psychotic disorders failed to reach statistical significance in their relationship with ACS, previous results suggest that they may still be associated with cardiovascular disease and mortality, the researchers noted. Limitations of the analysis include the studies’ underreporting of baseline characteristics, including precise follow-up duration, the type of heart attack experienced, and type of psychotropic medications taken.
Takeaway Message
“Although our results do not warrant changes in diagnostic strategies for patients with mental disorders, it is imperative that physicians remain objective and continue to provide high-quality physical health care to patients with mental disorders,” the researchers wrote.
Related Information
Source
Arnav Gupta, et al. Mental disorders as a risk factor of acute coronary syndrome: a systematic review and meta-analysis. JAMA Psychiatry. Published January 14, 2026. doi: 10.1001/jamapsychiatry.2025.4253.
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