Depression and Anxiety in Male Adolescents Linked to Increased Midlife MI Risk

Depression or an anxiety disorder in male adolescents was associated with a 20% increased likelihood of experiencing an acute MI in midlife, according to a Swedish national registry study presented at the virtual annual congress of the European Society of Cardiology.

The association was assessed partly by poor stress resilience as well as lack of physical fitness among the teenagers with an affective disorder, says Cecilia Bergh, PhD, of Obrero (Sweden) University, the lead author of the study.

Bergh and her associates included 238,013 males born in 1952-1956. They were aged 18-19 years when they underwent their conscription examination, at which time 34,503 of them either received or already had a diagnosis of depression or anxiety.

The mandatory conscription evaluation during the study years included a semi-structured interview with a psychologist to assess stress resilience through questions about coping with everyday life, a medical history and physical examination, and a cardiovascular fitness test using a bicycle ergometer.

The study came into existence by Sweden's comprehensive national health care registries coupled with the Nordic nation's compulsory conscription for military service.

The authors reported having no financial conflicts regarding the study and conducted free of commercial support.

A Cox regression analysis was carried out to assess the levels of adolescent cardiovascular risk factors, including blood pressure, body mass index, and systemic inflammation, as well as additional potential confounders, such as cognitive function, parental socioeconomic index, and a summary disease score.

Findings

• During follow-up from 1987 to 2010, a first acute MI occurred in 5,891 of the men. The risk was increased 51% among those with an earlier teen diagnosis of depression or anxiety.
• The midlife MI risk associated with adolescent depression or anxiety was attenuated, but still significant, with a 24% increase.
• Incorporating adolescent stress resilience and cardiovascular fitness, the increased risk of acute MI in midlife associated with adolescent depression or anxiety was further attenuated yet remained significant, at 18%.

"Effective prevention might focus on behavior, lifestyle, and psychosocial stress in early life. If a healthy lifestyle is encouraged as early as possible in childhood and adolescence, it is more likely to persist into adulthood and to improve long-term health. So look for signs of stress, depression, or anxiety that is beyond normal teenager behavior and a persistent problem", reported Dr. Bergh.

Based on the findings, the author concluded that "Teenagers with poor well-being could benefit from additional support to encourage exercise and also to develop strategies to deal with stress."