Psychological distress and risk of peripheral vascular disease, abdominal aortic aneurysm, and heart failure: pooling of sixteen cohort studies

Atherosclerosis. 2014 Oct;236(2):385-8. doi: 10.1016/j.atherosclerosis.2014.06.025. Epub 2014 Jun 30.


Objectives: Examine the little-tested relation of psychological distress with peripheral vascular disease, abdominal aortic aneurysm, and heart failure.

Methods: Pooling of raw data from 166,631 male and female participants in 16 UK-based cohort studies. Psychological distress was measured using the 12-item General Health Questionnaire. Peripheral vascular disease, abdominal aortic aneurysm, and heart failure events were based on death register linkage.

Results: During a mean follow-up 9.5 years there were 17,368 deaths of which 8625 were cardiovascular disease-related. Relative to the asymptomatic group (0 score), the highly distressed group (score 7-12) experienced an elevated risk of peripheral vascular disease (adjusted hazard ratio; 95% confidence interval: 3.39; 1.97, 5.82) and heart failure (1.76; 1.37, 2.26). Psychological distress was weakly related to the risk of death from abdominal aortic aneurysm. As anticipated, distress was associated with cardiovascular disease, coronary heart disease, and all strokes combined.

Conclusions: In the present study, we provide new evidence of mental health-related cardiovascular disease presentations.

Keywords: Abdominal aortic aneurysm; Cardiovascular disease; Epidemiology; Heart failure; Mental health; Peripheral vascular disease; Psychological distress.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / epidemiology*
  • Aortic Aneurysm, Abdominal / psychology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / psychology
  • Cause of Death
  • Cohort Studies
  • Coronary Disease / mortality
  • Coronary Disease / psychology
  • Cross-Sectional Studies
  • Disease Susceptibility
  • Female
  • Follow-Up Studies
  • Heart Failure / epidemiology*
  • Heart Failure / psychology
  • Humans
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / epidemiology*
  • Peripheral Vascular Diseases / psychology
  • Registries
  • Risk
  • Stress, Psychological / epidemiology*
  • Stroke / mortality
  • Stroke / psychology
  • United Kingdom / epidemiology
  • Young Adult