After a Heart Attack, Better Mental Health Care May Save Lives

Researchers have found that heart attack patients who exhibit certain personality traits, including sarcasm, pessimism, resentfulness, impatience, and irritability, are at a higher risk for dying from a second heart attack.

To conduct their study, which was published on September 14 in the European Journal of Cardiovascular Nursing, the researchers followed 2,321 heart attack patients for the first 24 months following their cardiac event. They assessed patient disposition using he Multiple Adjective Affect Checklist (MAACL).

Of all the subjects included, 57% were deemed "hostile," according to the MAACL.

After controlling for sex, age, education, marital status, diabetes, high blood pressure, and smoking, the researchers concluded that while hostility did not increase the risk of a second heart attack, it did predict higher death rates for patients who did.

"A heart attack is not just a one-time event," Jagdish Khubchandani, PhD, a professor of public health at New Mexico State University, tells Verywell. "Any chronic disease requires ongoing management. No matter how well you treat the initial issue, you must also include care for the patient's emotional needs."

How a Hospital Stay Can Impact Mental Health

For individuals who have been hospitalized, many factors contribute to a decline in their mental and emotional health, Khubchandani says. For example, patients can experience trauma, a lost sense of well-being, and severe sleep deprivation, which impairs cognition.

The phenomenon is not unique to heart attack patients. It's also seen in patients with other conditions, such as stroke.

Additional Risk Factors for Decline in Mental Wellness

Heart attack survivors who are depressed or anxious are less likely to eat properly or exercise, Khubchandani says. They often do not have strong support systems in place, and are more likely to turn to alcohol or drugs to cope with negative feelings.

"There is a lack of a comprehensive approach to cardiac health," Khubchandani says, suggesting mental health screening should be a part of treatment. "We have the ability to diagnose mental illness within minutes using simple tools."

Returning to Previous Activities After a Heart Attack

Patients who must return to a stressful work environment after a heart attack particularly need emotional support. "They are acclimating themselves back to a normal life," says Khubchandani, who co-authored a 2014 study published in the Journal of Community Health that showed how workplace harassment can have a detrimental impact on health outcomes, especially cardiovascular outcomes.

"Employers have a big responsibility in making sure these people have enough help," Khubchandani says. "Many offer counseling services and employee assistance programs. The idea is to be able to screen and find those people who are at risk for health issues."

Khubchandani says that "yoga, better communication techniques, early screening for mental health issues, and designing a course of therapy tailored to the patient," are all strategies that can help patients in the aftermath of a medical crisis.