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At Lantern, we believe it’s time to start thinking about new and different ways to support employee wellness. It’s time to embrace technology, and to break down barriers that keep employees from accessing care. Most of all, we believe it’s time to make mental health a core component of employee wellness programs. Because effective mental health programs not only improve employees’ sense of emotional well-being, but also reduce their susceptibility to common, life-threatening physical conditions. Today, we’re talking about one of those conditions in particular–heart disease–and its significant, often overlooked relationship to mental health.

Many of us know that heart disease is the leading cause of death in the U.S. Risk factors for heart disease like high cholesterol, high blood pressure, smoking, an unhealthy diet, excessive drinking, and a lack of exercise are common knowledge, but these only cover the physical risk factors and neglect the significant mental health component of cardiovascular disease.

Mental health challenges like anxiety, stress, and depression can increase the risk of developing a heart condition by changing how our cardiovascular system functions. For example, work stress can increase hormones like adrenaline and cortisol levels, which can impact both blood pressure and heart rate. It’s also hard to make conscious healthy choices (around food, exercise, smoking, and general self-care) if we have persistent feelings of low energy and depressed mood.

Anxiety and depression can not only accelerate the onset of heart disease, but also exacerbate an existing condition. To provide some context, the prevalence of major depressive disorder is remarkably high for people with heart disease and they are at a 56% higher risk of symptom exacerbation. Research shows between 30 and 40% of all people who’ve had coronary artery bypass graft (CAPG) surgery, a procedure used to treat coronary heart disease (CHD), are affected by depression. Imagine an employee suffers a heart attack, a stroke, or undergoes open heart surgery. Our immediate concern is that the physical damage is repaired, right? But it’s especially important for that employee to have access to mental health care to cope with the feelings of depression that often complicate the aftermath of a traumatic medical event.

Depression and anxiety can also act as barriers to care for people who need treatment for heart disease symptoms.  People experiencing both heart disease and mental health challenges could avoid medication or withdraw from treatment programs due to low motivation, lack of self-confidence, or a sense of hopelessness. These factors could simultaneously lead to heart disease progression and worsening mental health symptoms, reinforcing a negative cycle with poorer health outcomes. It’s important for employees to have access to appropriate mental health care, like early depression screenings, to ensure a highly preventive model of care.

Cardiac rehabilitation programs have shown to improve outcomes for people with previous cardiovascular disease. But lack of adherence to cardiac rehabilitation regimen and high dropout rates pose a significant problem in cardiology. And research shows that higher Hospital Anxiety Depression Scale scores, lower perceptions of consequences, and psychological distress, are key predictors of dropout. A randomized controlled trial found that a cardiac rehabilitation program that included CBT intervention, decreased the risk of recurrent heart disease and heart attack when compared to traditional care. This means that modifications to traditional CBT approaches have the potential to address the emotional and physical health challenges associated with cardiovascular disease.

When building a strong employee benefits program, it’s critical to think of health holistically to provide the best care possible and support employees’ physical and emotional well-being.