May 6 (UPI) -- A person's mental health may play a key role in the ability to recover after a heart attack and avoid having another one, according to a study presented Thursday during the American College of Cardiology's 70th annual scientific meeting.
Young and middle-aged adults who experienced severe psychological distress after a heart attack were more than twice as likely to suffer a second cardiac event within five years than those who reported only mild distress, the data showed.
This elevated risk was seen in heart attack sufferers who reported experiencing severe depression and anxiety, as well as other mental health problems, after their cardiac incidents, the researchers said.
"Outreach to the community has led to increased awareness of traditional heart disease risk factors and focus on things like diet and exercise, but many people, particularly younger people, may not be aware of the importance of mental health," study co-author Dr. Mariana Garcia said in a press release.
"Our study offers a strong message to people recovering from a heart attack that ameliorating psychological distress is equally important," said Garcia, a cardiology fellow at Emory University in Atlanta.
The findings align with previous studies that focus on older adults, bolstering the evidence for good mental health as an integral part of a person's recovery after a heart attack, according to the researchers.
For this study, Garcia and her colleagues analyzed health data for 283 heart attack survivors age 18 to 61.
Study participants completed a series of questionnaires measuring depression, anxiety, anger, perceived stress and post-traumatic stress disorder within six months of their heart attack, the researchers said.
Based on participants' responses, the researchers established a composite score of psychological distress for each and grouped them based on experiences of mild, moderate and high distress, they said.
Within five years after their heart attack, 80 of the 283 participants suffered a subsequent heart attack or stroke, were hospitalized for heart failure or died from heart-related causes.
A second heart attack or stroke, heart failure hospitalization or death from heart-related causes occurred in 47% of participants who reported experiencing high distress versus 22% of those who indicated that they were experiencing mild distress, the data showed.
Participants reporting high distress were more often Black, female and from a disadvantaged socioeconomic background.
They also were likely to smoke or have diabetes or high blood pressure than those who indicated mild distress, the researchers said.
In addition, participants who experienced high distress following a heart attack were found to have higher blood levels of two proteins -- interleukin-6 and monocyte chemoattract protein-1 -- that are considered signs of inflammation.
Previous studies suggest inflammation may increase due to psychological distress and that, in turn, may lead to additional heart problems, they said.
"Our findings suggest that cardiologists should consider the value of regular psychological assessments, especially among younger patients," Garcia said.
For young patients recovering from a heart attack, Garcia said they should work to reduce psychological distress with "meditation, relaxation techniques and holistic approaches, in addition to traditional medical therapy and cardiac rehabilitation."