A landmark ESC Clinical Consensus Statement presented at ESC Congress 2025 calls for greater recognition of the complex, two-way relationship between mental health and cardiovascular disease (CVD). It is the first statement of its kind developed by the European Society of Cardiology (ESC).
The Statement urges systematic mental health screening in cardiovascular care, alongside routine cardiovascular risk assessment for patients being treated for mental health conditions. It emphasises that poor mental health can contribute to CVD, while living with CVD also increases vulnerability to mental health disorders, together resulting in worse health outcomes.
The document was developed by an international panel of experts, co-chaired by Professor Héctor Bueno (CNIC and Hospital Universitario 12 de Octubre, Madrid, Spain) and Professor Christi Deaton (Emerita Professor of Nursing, University of Cambridge, UK).
The goal is to raise awareness of the multidirectional relationship between mental health and cardiovascular disease. Each increases the risk of the other, and individuals with both conditions have worse outcomes and the highest negative health burdens. In this consensus document, the experts summarise what they know about how to prevent or minimise negative outcomes, but also highlight significant gaps in their knowledge which need to be addressed urgently.
Key Recommendations
- Routine screening: Integrate mental health screening into cardiovascular appointments and assess cardiovascular risk in patients with mental health conditions.
- Psycho-Cardio Teams: Establish multidisciplinary care teams, including psychologists and psychiatrists, alongside cardiology professionals. These teams should be embedded in standard care and tailored to local needs.
- Risk assessment expansion: Include mental health and psychosocial risk factors in cardiovascular risk assessments for healthy individuals.
- Caregiver support: Provide psychological support to caregivers of patients living with both conditions.
The Statement advocates a cultural shift in cardiovascular care, calling for patient-centred models that fully integrate mental health. This would mark a significant departure from current practice, where mental health is rarely considered a primary treatment goal.
Clinical cardiovascular practice often overlooks the impact of mental health and the importance of its inclusion in care. There is a need for collaborations between cardiovascular and mental health professionals in Psycho-Cardio Teams to help identify early mental health conditions in patients and improve care and support for patients and their caregivers.
The Consensus Statement identifies critical barriers to progress, including limited awareness among healthcare professionals of the prevalence of mental health conditions and their role in increasing CVD risk, under-recognition of the impact of mental health on quality of life, adherence to treatment, and long-term outcomes in people with CVD and evidence gaps, including a lack of protocols for preventing CVD by supporting mental health in the general population, screening individuals with mental health conditions for cardiovascular risk and managing mental health conditions in patients with CVD.
Particularly concerning is the lack of data on severe mental illness (SMI). People living with SMI face increased risk of cardiovascular disease, arrhythmias, and sudden cardiac death due to the combined effects of distress, lifestyle risk factors, high prevalence of comorbidities, and some psychiatric medications. The Statement highlights the urgent need to recalibrate cardiovascular risk scores for this vulnerable population.
The authors stress that empowering patients to discuss mental health with cardiovascular professionals is essential for achieving timely assessment, management, and support. It is hoped that the Consensus Statement will spark a change that empowers patients to feel able to discuss their mental health with cardiovascular professionals, and that they will have a better chance of this being taken seriously.
Source: ESC
Image Credit: ESC
