Psychological Factors and Their Association with Ideal Cardiovascular Health Among Women and Men

This cross-sectional study of 9,056 employees examined whether self-reported adverse psychological factors — including stress, depression, anxiety, and hostility — were associated with achievement of ideal cardiovascular health as defined by the American Heart Association’s Life’s Simple Seven metrics.

Stress and depression were associated with significantly lower odds of achieving optimal or average cardiovascular health scores in both women and men. Additional psychological factors showed significant associations primarily among women. There were no strong sex-by-factor interactions, suggesting the relationship is not fundamentally different between the sexes.

The cross-sectional design cannot establish causality or direction: psychological distress may reduce healthy behaviors, or poor cardiovascular health may cause psychological distress, or both may share upstream causes. Self-reported psychological factors also introduce measurement imprecision.

We rate the evidence limited. A large workplace study identifying an association between psychological distress and cardiovascular health metrics; the cross-sectional design prevents causal inference, but the signal is consistent with a growing literature on psychosocial determinants of cardiovascular risk.