Cardiovascular disease how stress and depression affect the heart

Every year, around 340 people die.000 people nationwide suffer from cardiovascular disease. A DAK report shows that the role of stress and mental illness as a risk for heart attacks is underestimated.

Soon one fifth of the working population in Germany will be affected by a mental risk factor for cardiovascular disease. This is the result of the current DAK Health Report. Extrapolated to the working population, 8.6 million people have an increased risk of heart attack due to mental illness or work-related stress. The study also shows that physical risk factors such as smoking, high blood prere or obesity are often accompanied by psychological risks.

"For years, the number of absences from work due to mental illness has been on the rise. Given these highs, which we see especially during the pandemic, we need to be vigilant", says Andreas Storm, Chairman of the Board of the DAK health insurance company. "Depression, anxiety and negative stress are already a major burden in themselves. But they also literally go to the heart!" The report shows an increase of 41 percent in the number of days lost due to mental illness from 2011 to 2021. After musculoskeletal disorders, mental illnesses are the second most common reason for days of absence among employees.

For the Health Report, the Forsa Institute surveyed around 7100 employed women and men aged 18 to 65 on behalf of DAK. And the IGES Institute analyzed the data of more than two million employed DAK-insured persons.

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Psychological risk factors often do not come alone

Nearly one-fifth of respondents live with a mental risk of cardiovascular disease, according to the survey. At 22 percent, slightly more women than men (16 percent) report problems in this regard. But the psychological risk factors often come still with further physical risk factors together. These include smoking, high blood prere, obesity, elevated cholesterol levels and overweight. One reason: "Behavior affects the psyche and vice versa", says Professor Christoph Herrmann-Lingen, Director of the Clinic for Psychosomatic Medicine and Psychotherapy, Gottingen University Medical Center. People with a mental illness are often unable to behave healthily. For a depressed person, for example, it is not possible to do regular sports because of their condition, the expert says.

Nearly one-third of respondents who have a mental health risk factor also report being overweight. And well over a quarter count themselves as smokers. By comparison, among respondents without mental risk, the proportion of people with severe obesity is much lower at just under 23 percent, and only one-fifth of them smoke.

The report also shows that working people with depression are more often in medical treatment for coronary heart disease, in which the coronary arteries slowly close and an acute heart attack can occur even in middle age. "For one thing, people with mental illnesses are more likely to develop heart problems. On the other hand, in many cardiovascular patients we see a mental illness as a consequence", explains Christoph Herrmann-Lingen. In the outpatient care of people with depression, the cardiovascular risk should always be taken into account, and after a heart attack, for example, regular attention should be paid to mental illness in rehab, says the expert.

Work stress as a burden on the heart

However, the risk of cardiovascular disease is not only increased for people with mental illnesses. Work stress is also a factor. Nine percent of respondents suffer from heart-threatening work stress. Work stress in the sense of the study affects people who work hard or at least see it that way and at the same time receive little appreciation. At almost eleven percent, work stress is particularly high among people with an average professional qualification such as vocational training. It is lowest among academics: inside at around five percent.

cardiovascular disease how stress and depression affect the heart

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Cardiovascular diseases cause an average of 60 days of absence per year per 100 insured persons – more for men, less for women. The number of days of absence increases significantly with age. 45- to 49-year-old men have 67 days of cardiovascular disease per 100 insured persons, while their colleagues ten years older have 184 days – almost three times as many. DAK Chairman Andreas Storm sees employers as having a duty to keep an eye on stress, strain and the mental and physical health of their employees: inside and to protect them. Christoph Herrmann-Lingen explains that prevention is best started at a very early stage, because the course for both cardiovascular diseases and mental illnesses is set at an early stage in life. Timely support for children in precarious circumstances, for example, could have a preventive effect.

According to the study, just under half (48 percent) of employees are offered workplace health promotion services by their company. Among those at work, only 41 percent are at increased risk for cardiovascular disease. Prevention is very important for cardiovascular diseases, stresses Storm. Health insurers also offer numerous courses on how to change one's lifestyle. People who smoke less, exercise more, eat healthier, relax more and have a healthier work life lower their risk of cardiovascular disease. For those with statutory health insurance, an annual check-up is also free of charge every three years from the age of 35. Medical check-ups can detect possible risk factors at an early stage, he says.

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