From brain to heart: self-perceived emotional distress, cardiovascular symptoms burden, and cardiovascular risk in a population-based screening program
I Santoyo-Perez, J Ascencio-Guerrero, D G Gomez Revilla Mancilla, V Ortega Albarran, H Marrufo-Rizo, J E Gonzalez Lopez, J Noriega Saldana, D I Cardoso Casco, E F Carrizales Sepulveda, J Swain Saint Martin, J C Perez Bustamante, I U Diaz Ramirez, J A Vazquez Acosta, Y G Anguiano Ramos, L F Aguilera MoraAbstract
Background
Mental health illness, particularly anxiety and depression, are recognized as important contributors to cardiovascular symptom burden and long-term cardiovascular disease (CVD) risk. Psychosocial stress can trigger autonomic imbalance, endothelial dysfunction, and heightened symptom perception. However, data from population-based screening programs evaluating the relationship between mental health status, cardiovascular symptoms, and calculated CVD risk remain limited in Latin American populations.
Purpose
To evaluate the association between mental health status and the prevalence of cardiovascular symptoms, and estimated 10-year cardiovascular disease risk calculated through the Globorisk-LAC equation in adults participating in a population-based screening program.
Methods
We conducted a cross-sectional analysis of adults aged 40 to 74 years, enrolled in a population-based cardiovascular screening program between 2021-2025, participation was voluntary, individuals attended on their own initiative and were not recruited due to acute illness or ongoing clinical complaints. Mental health status and cardiovascular symptoms, including chest pain, palpitations, dyspnea, dizziness, and syncope, were patient-reported. The 10-year cardiovascular risk was calculated using the Globorisk-LAC equation for all eligible participants. Multivariable logistic model was used to examine associations between mental health status, cardiovascular symptoms, and estimated cardiovascular risk, adjusting for age, sex, lifestyle factors, and clinical comorbidities.
Results
A total of 1831 participants with a median age of 56 years, mostly female 63%, were included. Mental disorders were identified in 23% of the population, with anxiety being the most common (6%). In adjusted models, individuals with mental health disorders showed a higher risk of presenting dyspnea at rest (OR 1.66, 95% CI 1.204-2.309, p 0.002), and presyncope or dizziness (OR 1.322, 95% CI 1.021-1.712, p 0.034). No significant associations were observed for the remaining cardiovascular symptoms (all p > 0.05). Likewise, the presence of mental health disorders was not significantly associated with an increased 10-year cardiovascular risk derived from the Globorisk-LAC equation.
Conclusions
In this population-based screening cohort, self-perceived emotional distress was common and was independently associated with a higher likelihood of patient-reported dyspnea at rest and presyncope/dizziness, but not with other cardiovascular symptoms. Importantly, self-perceived emotional distress was not associated with the estimated 10-year cardiovascular risk calculated using the Globorisk-LAC equation. These findings highlight the selective cardiovascular symptom burden linked to mental health conditions and underscore the need to integrate mental health assessment into community-level cardiovascular evaluations.From Brain to Heart-Tables