Psychological distress has a strong dose-dependent association with both myocardial infarction and stroke in both men and women, data from the Sax Institute’s NSW 45 and Up study shows.

Presented overnight at the European Society of Cardiology Congress in Munich the study involving 221,677  participants found high or very high levels of distress were associated with a 30% increased risk of MI in men aged 45 to 79 years and an 18% increased risk in women of the same age.

Similar estimates were seen for stroke, with high/very high psychological distress associated with a 24% and 44% increased stroke risk in men and women, respectively, with no evidence of interaction with age or sex.

“These associations persist despite adjustment for a wide range of confounders and provide further support for a direct mechanism linking psychological distress and myocardial infarction and stroke,” the study authors noted in their paper published simultaneously in Circulation: Cardiovascular Quality and Outcomes.

According to the research team their findings suggest that psychological distress might operate partly through lifestyle behaviours but also support the view that other mechanisms may exist.

“ Irrespective of the causal nature of the association between psychological distress and CVD, growing evidence supported the need for renewed efforts: to encourage people with symptoms of psychological distress to seek medical help; for more active screening of, and better treatment for, psychological distress (and diagnosed common mental disorders); and to encourage screening for traditional cardiovascular risk factors,” they wrote.