Highmark, Penn State research finds diseases of despair associated with higher risks of cardiovascular disease

PITTSBURGH (October 5, 2023) — Individuals with a diseases of despair diagnosis are 42 percent more likely to develop a cardiovascular condition, according to a retrospective study by Highmark Health Enterprise Analytics and the Penn State Clinical and Translational Science Institute (CTSI).

During the past 15 years, life expectancy has decreased while premature deaths have increased across the United States. The trend is partly driven by a rise in diseases and deaths related to alcohol use, drug use, and self-harm, otherwise termed by researchers as diseases of despair (DoD). Another contributing factor to this trend includes preventable, cardiovascular diseases such as heart disease and stroke.

Researchers at Highmark Health, Allegheny Health Network, and the Penn State College of Medicine continued their research on DoD using national Highmark insurance claims to investigate the association between DoD and the subsequent incidence of atherosclerotic cardiovascular disease (ASCVD).

“Highmark and Penn State have collaborated on several studies related to diseases of despair over the past 5 years,” said Emily Brignone, PhD, Director of SDoH and Research Enablement Analytics at Highmark. “In this particular study, we found that individuals who had a DoD diagnosis at the beginning of the study were far more likely to go on to develop cardiovascular disease than those without. This was true for both men and women and across all age groups. We also found that every type of DoD increased risk for cardiovascular disease, and this risk was higher still for those with more than one type of DoD diagnosis.”

The research team found that individuals with substance-related disorders alone had 50 percent higher risk of ASCVD, similarly, those with alcohol-related disorders or self-harm had 33 and 30 percent higher risk, respectively. Individuals with both substance-related disorders and self-harm had double the risk of ASCVD.

“What patients and members can take away from this study is that mental and behavioral health conditions may have far reaching effects on physical health,” says Matthew Nudy, MD, Penn State Health cardiologist and assistant professor of medicine and public health sciences at Penn State College of Medicine. “Future research should focus on the efficacy of cardiovascular screening and prevention strategies in those affected by DoD.”

The study was supported dually by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant UL1 TR002014, and with funds provided by the Highmark Health Research Institute.

To learn more about the ongoing study’s findings:

• BMJ Open (Published 6 September 2023)
  Association between diseases of despair and atherosclerotic cardiovascular disease among insured adults in the USA: a retrospective cohort study from 2017 to 2021
• JAMA Network Open (Published 23 July 2021)
  Perceptions of Diseases of Despair by Members of Rural and Urban High-Prevalence Communities: A Qualitative Study | Public Health | JAMA Network Open | JAMA Network
• BMJ Open (Published 9 November 2020)
  Trends in the diagnosis of diseases of despair in the United States, 2009–2018: a retrospective cohort study | BMJ Open