Singh Ajeet, Riaz Rumaisa, Verma Amogh, Irfan Hamza, Shaukat Ayesha, Nadeem Abdullah, Goyal Priya, Habib Ashna, Satapathy Prakasini
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Internal Medicine, Rama Medical College Hospital and Research Center, Hapur, India.
Ann Med Surg (Lond). 2025 May 29;87(8):4963-4974. doi: 10.1097/MS9.0000000000003391. eCollection 2025 Aug.
This review explores the bidirectional relationship between mental health disorders and cardiovascular disease (CVD), highlighting the potential of integrated healthcare models to improve outcomes. While CVD remains the leading cause of global mortality, traditionally linked to risk factors like hypertension and diabetes, emerging evidence shows that mental health conditions, especially depression and anxiety, significantly increase CVD risk through mechanisms such as chronic stress, inflammation, and neuroendocrine dysregulation. Activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system exacerbates inflammation, elevates blood pressure, and contributes to cardiovascular risk factors. Moreover, the psychological burden of CVD often worsens mental health, creating a vicious cycle that complicates treatment adherence and patient management. Integrated care models offer a holistic approach to address these interconnected issues, potentially improving clinical outcomes, reducing healthcare costs, and enhancing patient adherence. This review also explores the role of telehealth and digital health interventions in overcoming accessibility barriers, particularly for underserved populations. Finally, policy recommendations emphasize the need for increased funding, professional training in interdisciplinary care, and targeted outreach to ensure equitable access to integrated care. By addressing both CVD and mental health challenges, these models could improve quality of life and reduce the global burden of these intertwined diseases.
本综述探讨了心理健康障碍与心血管疾病(CVD)之间的双向关系,强调了综合医疗模式改善治疗效果的潜力。虽然心血管疾病仍然是全球死亡的主要原因,传统上与高血压和糖尿病等风险因素相关,但新出现的证据表明,心理健康状况,尤其是抑郁症和焦虑症,会通过慢性应激、炎症和神经内分泌失调等机制显著增加心血管疾病风险。下丘脑-垂体-肾上腺轴和交感神经系统的激活会加剧炎症、升高血压,并导致心血管危险因素。此外,心血管疾病的心理负担往往会使心理健康恶化,形成一个恶性循环,使治疗依从性和患者管理变得复杂。综合护理模式提供了一种整体方法来解决这些相互关联的问题,有可能改善临床结果、降低医疗成本并提高患者依从性。本综述还探讨了远程医疗和数字健康干预在克服可及性障碍方面的作用,特别是对服务不足人群而言。最后,政策建议强调需要增加资金、开展跨学科护理专业培训,并进行有针对性的宣传,以确保公平获得综合护理。通过应对心血管疾病和心理健康挑战,这些模式可以提高生活质量并减轻这些相互交织疾病的全球负担。