Low level stress can raise the risk of fatal heart attacks and stroke by twenty per cent, scientists have warned.
Research has found symptoms of anxiety or depression, known as psychological distress, increases mortality rates from several major causes.
But, alarmingly, the risk rose among those at the lower end of the scale who would not usually come to the attention of mental health services - about a quarter of people.
Researchers have found being stressed puts you at a higher risk of dying from stroke or heart disease
Dr Tom Russ, of Alzheimer Scotland Dementia Research Centre at the University of Edinburgh, said: 'We found psychological distress was a risk factor for death from all causes, cardiovascular disease, and external causes - the greater the distress, the higher the risk.
'However, even people with low distress scores were at an increased risk of death. Currently these people - a quarter of the adult population - are unlikely to come to the attention of mental health services due to these symptoms and may not be receiving treatment.'
Previous studies investigating the association between psychological distress and mortality have been small and unable to reliably measure thresholds of risk.
So the researchers analysed data from more than 68,000 over 35s years who took part in the Health Survey for England from 1994 to 2004 and measured the role of anxiety and stress in deaths from all causes, heart disease, cancer and external causes occurring over eight years.
Psychological distress was calculated using a recognised scale ranging from no symptoms to severe and death certificates were used to record the cause of death.
Dr Russ said: 'If you score one, two or three on this scale you may be suffering some form of social dysfunction or loss of confidence but your GP will not diagnose you with psychological distress.
The research measured the role of anxiety and stress in deaths from all causes, heart disease, cancer and external causes occurring over eight years. Pictured are defibrillator paddles used to treat heart disease victims
'But the risk of death among this group of the population from cardiovascular disease, which includes heart attacks and stroke, and external factors such as accidents or suicide rose by an average of a fifth.
'For those at the highest end of the scale with severe symptoms of anxiety and depression the risk almost doubled.'
Dr David Batty, of University College London, said: 'These associations also remained after taking into account other factors such as weight, exercise, smoking, alcohol consumption and diabetes.
'Therefore this increased mortality is not simply the result of people with higher levels of psychological distress smoking or drinking more, or taking less exercise.'
The study published online in the British Medical Journal is the largest to show a dose-response relation between psychological distress and mortality and has potentially important implications for treatment.
Dr Russ added: 'The fact an increased risk of mortality was evident, even at low levels of psychological distress, should prompt research into whether treatment of these very common, minor symptoms can modify this increased risk of death.'
Professor Glyn Lewis, of the University of Bristol, reviewed the findings for the journal and said they add to evidence suggesting a causal association between psychological distress and heart disease, although it is not clear how to intervene.
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