Addressing the Toll of Heart Disease on Persons with Behavioral Health Conditions

Over the next five years, more than 3 million Americans will die from heart-related ailments, including heart attack and stroke. Even more tragic for us is the fact that one-third of these deaths—about 1 million persons—will be people who have a mental health or substance use condition.

We have known for some time that persons with behavioral health conditions are at particular risk of heart disease. Specifically, depression increases blood cortisol, which increases the risk of heart attack; smoking, a potent risk factor, is very prevalent among those with behavioral health conditions; use of psychotropic medications frequently leads to the metabolic syndrome and obesity, which increases risk; and excessive alcohol use can exacerbate high blood pressure and trigger a stroke or heart attack.

We have also known another tragic fact: Persons with severe behavioral health conditions are likely to die 25 years or more prematurely. In addition to the risk factors noted above, most of these persons lack access to any primary care.

Realization of this very serious problem has led to several large scale efforts: First, the US HHS has implemented the Million Hearts Campaign. This campaign aims to prevent 1 million heart attacks and strokes over the next five years. Second, SAMHSA initiated a 10 by 10 Campaign and more recently a 10 by 10 Wellness Initiative.

This presentation will analyze the problem, the federal response, and the role that local providers and consumers can play in this effort. The problem is tragic and the need is urgent.