Source: Sinitta Leunen/Unsplash

It’s well-known that people with depression are more likely to suffer from heart disease (and vice versa). But doctors and parents may not be thinking about the problem in the young and taking action. That's a mistake because depression, anxiety, or bipolar illness at a young age increases the chance of heart trouble down the line.

For example, in a study of nearly 420,000 men evaluated at age 18 or 19 for military service in Sweden, the men who showed signs of depression or anxiety then had a 20 percent higher chance of suffering a heart attack by age 58.

This was so even after taking into account their blood pressure, body mass index, general health, and parents’ socioeconomic status. A remedy? Coaching to help young people manage stress and stay fit through exercise, the researchers said.

Other research looked at a large group of American adults up to age 49, including more than 18,700 people between the ages of 18 to 29. It concluded that depression more than doubled the odds of cardiovascular disease (CVD), which includes heart attacks and strokes as well as other problems with the heart and blood vessels.

The link between heart disease and depression has been observed even in children. A study of 77 patients in a pediatric depression program found that 46 percent had a family history of early CVD. A quarter of them had high blood pressure and 28 percent had high total cholesterol. More than half of the participants had at least two CVD risk factors. The researchers recommended that depressed children routinely be screened for CVD, even if they aren’t overweight.

One problem is that young people, even more than other Americans, eat junk food, putting their hearts at risk. They also don’t exercise enough: In one study, only 14 percent of 11 to-19-year-olds had high marks in a scoring system that included diet, physical activity, and body mass index. In a classic bad loop, a poor diet and lack of exercise aggravate low mood, and low mood leads to more lying around and snacking or binging.

As early as 2015, after analyzing published studies of heart attacks and deaths among young people, an AHA committee of medical experts found that teens with major depression or bipolar disorder are more likely than other youngsters to have a host of CVD risk factors, including hardening of the arteries.

Mental health is a problem for many American teens. The latest, pre-pandemic, figures from the CDC report that among adolescents aged 12-17 years, more than 15 percent had a major depressive episode, nearly 37 percent had persistent feelings of sadness or hopelessness, nearly 19 percent seriously considered attempting suicide, and 9 percent made an attempt.

Teens with mood disorders are more likely to smoke or abuse other drugs and avoid exercise. They also may be taking medications that increase blood pressure and can cause higher cholesterol. However, those factors don't entirely explain why these young people would have higher rates of CVD.

The bottom line for parents: Make sure your child is getting some exercise and eating a healthful diet (less red meat and more fish, plenty of vegetables and whole grains). With teens, you may need to talk to them to explain that they run more of a risk of heart disease if they choose to smoke or abuse drugs.