Psychiatric disorders and cardiovascular diseases: A mendelian randomization study
Xiaohui Sui1, Tingting Liu1, Yi Liang1
1Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250014, China.
Insights
Mendelian randomization analysis reveals that attention deficit hyperactivity disorder, schizophrenia, major depressive disorder, and bipolar disorder have causal links to cardiovascular diseases. These findings suggest psychiatric disorders can influence cardiovascular health, aiding in prevention strategies.
Area of Science:
- Genetics and Epidemiology
- Psychiatry
- Cardiology
Background:
- Established associations exist between psychiatric disorders and cardiovascular diseases (CVDs), but causality remains unclear.
- Investigating the causal relationship is crucial for understanding disease mechanisms and developing targeted prevention strategies.
Purpose of the Study:
- To employ Mendelian randomization (MR) to determine the causal effects of psychiatric disorders on the risk of developing CVDs.
- To provide genetic evidence for the bidirectional relationship between mental health and cardiovascular health.
Main Methods:
- Utilized genome-wide association study (GWAS) summary data for four CVDs (coronary artery disease, atrial fibrillation, heart failure, ischemic stroke) and four psychiatric disorders (bipolar disorder, major depressive disorder, schizophrenia, ADHD) in a European population.
- Applied the inverse-variance weighted (IVW) method as the primary analysis, with sensitivity analyses including MR-Egger, Cochrane's Q test, MR-PRESSO, and leave-one-out analysis to ensure result robustness.
Main Results:
- Attention deficit hyperactivity disorder (ADHD) was associated with increased risk of atrial fibrillation, heart failure, and ischemic stroke.
- Schizophrenia showed an increased risk for heart failure and a suggestive inverse association with coronary artery disease.
- Major depressive disorder was linked to higher odds of coronary artery disease, while bipolar disorder was associated with reduced risks of coronary artery disease and heart failure.
Conclusions:
- The study provides robust genetic evidence supporting a causal link between specific psychiatric disorders and CVDs.
- Findings indicate that certain psychiatric conditions may predispose individuals to CVDs, influencing risk factors and outcomes.
- These insights can inform clinical practice and public health initiatives for CVD prevention in individuals with mental health conditions.
Background:
Previous researches have demonstrated a connection between psychiatric disorders and cardiovascular diseases (CVDs), but the cause-and-effect relationship is still unclear. To that goal, the mendelian randomization (MR) method was used to study the causal link between psychiatric disorders and CVDs.
Methods:
Genome-wide association studies (GWAS) data were collected for four CVDs, including coronary artery disease (n = 547,261), atrial fibrillation (n = 537,409), heart failure (n = 977,323) and ischemic stroke (n = 440,328). Summary data for four psychiatric disorders, including bipolar disorder (n = 51,710), major depressive disorder (n = 480,359), schizophrenia (n = 127,906) and attention deficit hyperactivity disorder (n = 55,374), came from the Psychiatric Genomics Consortium (PGC). All participants were European. The IVW method was mainly used, and the reliability of the results was increased using sensitivity analyses such as MR-Egger, Cochrane's Q test, MR-PRESSO and leave-one-out.
Results:
MR revealed that the attention deficit hyperactivity disorder was linked to an increased risk of atrial fibrillation (OR, 1.085; 95% CI, 1.021-1.153; P = 0.008), heart failure (OR, 1.117; 95% CI, 1.044-1.195; P = 0.001), and ischemic stroke (OR, 1.146; 95% CI, 1.052-1.248; P = 0.002). The schizophrenia was linked to an increased risk of heart failure (OR, 1.035; 95% CI, 1.006-1.066; P = 0.017), but was found to be suggestively inverse associated with coronary artery disease (OR, 0.969; 95% CI, 0.941-0.997; P = 0.03). The major depressive disorder was associated with higher odds of coronary artery disease (OR, 1.109; 95% CI, 1.018-1.208; P = 0.018), while the bipolar disorder was linked to a reduced incidence of coronary artery disease (OR, 0.894; 95% CI, 0.831-0.961; P = 0.002) and heart failure (OR, 0.889; 95% CI, 0.829-0.955; P = 0.001). There were no clear relationships between other psychiatric disorders and CVDs.
Conclusion:
The results provide genetic proof of a possible causal relationship between psychiatric disorders and CVDs. These results imply that psychiatric disorders may be the cause of some CVDs, and that some abnormal mental states may increase or reduce the likelihood of CVDs, providing guidance for the CVDs prevention.
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