Can anxiety and depression be risk factors for coronary heart disease? What is the evidence, and the clinical implications?
It has long been recognised that patients with significant psychiatric disorders have increased mortality from a range of medical conditions, most commonly cardiovascular diseases. It was widely believed that this increased risk was largely attributable to the adverse ‘lifestyle’ risk factors of patients with depression, such as smoking, poor exercise, obesity and alcohol consumption. However, recent evidence shows that this is by no means the major explanation for the association.