WHAT IS PSYCHOCARDIOLOGY?

A 2018 article in the Psychiatric Times noted that, though interactions between the heart and brain have been recognized for thousands of years, the subject continues to gain complexity. Today, they are believed to be more multifaceted—and much more closely interrelated—than experts once thought.

In 2013, the medical journal Future Cardiology reported on the connection between cardiovascular disease and psychiatric illnesses such as mood and anxiety disorders. Authors pointed to numerous studies confirming that these frequently overlap in an individual (also called high comorbidity).

This comorbidity, they added, was bidirectional. In other words, heart conditions can increase the risk for psychiatric illnesses, while mental health conditions (as well as high stress levels) can negatively impact heart health. Psychocardiology explores this heart-mind connection.

By 2022, an editorial in Frontiers in Psychiatry listed several recent studies that examined this link. They led to various conclusions supporting the brain-heart connection:

• Stress has been shown to negatively affect the heart. Evidence points strongly to stressors as triggers of coronary events.
• Loneliness, social isolation, anger, and depression may contribute to cardiac events.
• Stress reduction practices may help reduce the risk of cardiovascular disease.
• Depression may lead to poorer outcomes in patients who experience cardiac issues, including increased risk of death. Depression is also associated with elevated risk for developing cardiovascular disease.
• Anxiety and posttraumatic stress disorder (PTSD) may be related to both cardiovascular events and cardiovascular disease.
• Symptoms of psychosis—including schizophrenia and bipolar disorder—have been linked with cardiovascular risk or incidence, but more research is needed on this connection.

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THE HEART-BRAIN CONNECTION EXPLAINED

Researchers have established that the heart-brain connection is forged through the autonomic nervous system. Therefore, cardiac function “can be profoundly altered by…central autonomic commands, including those associated with stress, physical activity, arousal, and sleep.”

It helps explain how mental health affects heart health—and vice versa. Some examples include:

• Chronic stress and heart disease: Unfortunately, emotional stress and heart problems go together. Stress creates frequent cortisol surges, which in turn can damage arteries. A 2017 study established a link between stress-related activity in the brain’s amygdala and increased risk of cardiovascular disease.
• Anxiety and heart health: Anxiety triggers symptoms that can impact heart health. Johns Hopkins Medicine reports that rapid heart rate, increased blood pressure, heart palpitations, and decreased heart rate variability can increase the risk of cardiac events, heart failure, and death after a heart attack.
• Depression and heart disease: Inflammation is a key factor in numerous diseases, including heart disease and depression, and heart patients are at higher risk for mood disorders.

A 2017 report on heart disease and depression noted that “adults with a depressive disorder or symptoms have a 64 percent greater risk of developing coronary artery disease (CAD); and depressed CAD patients are 59 percent more likely to have a future adverse cardiovascular event, such as a heart attack or cardiac death.”

• PTSD and heart attacks: Once called “Soldier’s Heart,” trauma (including PTSD) increases the risk of cardiovascular concerns.
• Inflammation and brain function: Cardiovascular problems can contribute to cognitive decline. A 2022 review explained that, compared to the general population, patients with heart failure have reduced cognition and increased dementia risk. This may be due to changes such as reduced brain volume, reduced blood supply to the brain, and inflammation.
• Post-heart attack symptoms: Surviving a cardiac event can trigger mental health symptoms, including PTSD, depression, anxiety, and grief.

As a crucial part of the autonomic nervous system, the vagus nerve plays a major role in the brain-heart connection. This can help guide beneficial treatments.

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For example, a 2020 study explored vagus nerve stimulation as a therapy for cardiovascular issues. Authors noted that because the vagus nerve helps maintain physiological homeostasis, it interacts with the reflex pathways that regulate cardiac function.

The study further pointed out that vagus nerve activity, called vagal tone, has been linked with heart rate variability, which can reflect the body’s stress resilience and cardiovascular health. The vagus nerve also regulates sleep, mood, pain, stress, and hunger, making it a major factor in mental health.

Press Play to Discover More About Heart Health Risk Factors

In this video, Amen Clinics integrative nutritionist Cindy Santa Ana discusses the risk factors that increase your chances of getting heart disease, as well as some simple tips to reduce your risk.

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