Stress identified as possible link between depression and heart disease risk: Study - Video

Stress doesn't just weigh on your mind-it can strain your heart too. A large new study from Mass General Brigham has found that people with depression and anxiety face a higher risk of cardiovascular disease, and that this connection appears to be driven by stress-related brain activity, nervous system imbalance, and chronic inflammation. Published in Circulation: Cardiovascular Imaging, the findings highlight how emotional distress can biologically “get under the skin,” influencing the body’s cardiovascular system in measurable ways.

Depression and anxiety are two of the most common mental health conditions worldwide, and both have long been linked to higher rates of heart attack, heart failure, and stroke. To better understand why, researchers analyzed medical and behavioral data from 85,551 adults enrolled in the Mass General Brigham Biobank. Among them, 14,934 had both depression and anxiety, 15,819 had one, and 54,798 had neither. Participants were tracked for a median of 3.4 years, during which 3,078 experienced major cardiovascular events.

The analysis revealed a clear pattern: individuals with depression or anxiety had a higher risk of cardiovascular disease, but those with both conditions faced about a 32% greater risk than patients with only one. These differences remained significant even after accounting for lifestyle factors such as smoking, exercise, diet, and medical conditions like diabetes or hypertension.

To probe deeper, the researchers studied advanced brain imaging and biomarkers of stress in a subset of participants. Those with depression or anxiety showed heightened activity in the amygdala—the brain’s stress center—alongside lower heart rate variability (indicating an overactive “fight-or-flight” response) and elevated blood levels of C-reactive protein (CRP), a marker of inflammation. Together, these changes form a biological chain: ongoing stress overactivates the nervous system, raises blood pressure and heart rate, and fuels inflammation—all of which damage blood vessels over time.

“This research shows that managing your emotional health is managing your heart health,” said Dr. Shady Abohashem, lead author of the study. The team is now testing whether stress reduction therapies, anti inflammatory drugs, or lifestyle interventions can help normalize these biological signals and, ultimately, protect the heart.

For patients, the message is simple but powerful: caring for your mind could be one of the best things you do for your heart.

REFERENCE: Abohashem, S., et al. (2025) Depression and Anxiety Associate with Adverse Cardiovascular Events via Neural, Autonomic and Inflammatory Pathways. Circulation: Cardiovascular Imaging. DOI: 10.1161/CIRCIMAGING.124.017706. https://www.ahajournals.org/doi/10.1161/CIRCIMAGING.124.017706