Washington DC: Relax your mind if you have a heart disease, as a study has found that people, who persistently experience moderate to severe mental distress are at increased risk of death.


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According to researchers, people with persistent mental distress, including depression and anxiety, were nearly four times as likely to have died of cardiovascular disease and nearly three times as likely to have died from any cause.


The team analysed the association between occasional or persistent mental distress and the risk of death in 950 people with stable coronary heart disease, who were between 31 and 74 years old.


All the participants were part of the Long Term Intervention with Pravastatin in Ischaemic Disease Trial and had had a heart attack or been admitted to hospital for unstable severe pain in the chest in the preceding three to 36 months.


They filled in a validated general health questionnaire (GHQ30) at six months, one, two and four years.


This was graded according to severity and the length of time it lasted at each of the assessments: never distressed; occasional (of any severity); persistent mild distress on three or more occasions; and persistent moderate distress on three or more occasions.


The participants` health and survival were then tracked for an average of 12 years.


They found that 398 people died from all causes and 199 died from cardiovascular disease.


The questionnaire responses showed that 587 (62 percent) of participants said they had not been distressed at any of the assessments, while around one in four (27 percent) said they had experienced occasional distress of any severity.


The findings suggested that in patients with stable [coronary heart disease], long term mortality risk is related to the cumulative burden of psychological distress.


Dr Gjin Ndrepepa from the Technical University, Munich, Germany, describes the research as an "important and elaborative study which helps to uncover the intricate relationship between psychological distress and cardiovascular disease.


Nevertheless, mental distress activates the sympathetic nervous system and boosts stress hormone levels, which, if persistent, can produce potentially harmful physiological changes, some of which may be permanent, he explained.


The study is published online in the journal Heart.