Older adults who experience psychological distress such as depression and anxiety may have an increased risk of developing cardiovascular disease (CVD), a new study suggests.

The findings, published in the journal Circulation: Cardiovascular Quality and Outcomes, showed that high/ very high psychological distress was associated with a 44 per cent increased risk of stroke among women.

The research team also found that in men aged between 45 to 79, high/ very high versus low psychological distress was associated with a 30 per cent increased risk of heart attack, with weaker estimates in those 80 years old or older.

“While these factors might explain some of the observed increased risk, they do not appear to account for all of it, indicating that other mechanisms are likely to be important,” said senior author Caroline Jackson from the University of Edinburgh.

For the study, the team involved 221,677 participants from Australia who had not experienced a heart attack or stroke at the start of the study.

The researchers categorised psychological distress as low, medium and high/ very high using a standard psychological distress scale which asks people to self-assess the level.

The 10-question survey asked questions such as: “How often do you feel tired out for no good reason? How often do you feel so sad that nothing could cheer you up? How often do you feel restless or fidgety?”

Of the participants — 102,039 men (average age 62) and 119,638 women (average age 60) — 16.2 per cent reported having moderate psychological distress and 7.3 per cent had high/ very high psychological distress.

During follow-up of more than four years, 4,573 heart attacks and 2,421 strokes occurred, the research team found.

The absolute risk — overall risk of developing a disease in a certain time period — of heart attack and stroke rose with each level of psychological distress, they said.

The association between psychological distress and increased cardiovascular disease risk was present even after accounting for lifestyle behaviours (smoking, alcohol intake, dietary habits, etc.) and disease history, the researchers said.