Petras Navickas1, Laura Lukavičiūtė1, Alvydas Navickas1,2, Pranas Šerpytis1,3,4, Rokas Šerpytis1,3
1Vilnius University Medical Faculty, Vilnius, Lithuania
2Vilnius University Medical Faculty Psychiatric Clinic, Vilnius, Lithuania
3Vilnius University Hospital Santariškių Klinikos, Centre of Cardiology and Angiology, Vilnius, Lithuania
4Vilnius University Hospital Santariškių Klinikos, Centre of Emergency Medicine, Vilnius, Lithuania
Background and objective: There are many theories regarding the reasons why there is such a wide diversity of incidence rates of both cardiovascular and mental health disease across Europe and the world. Although both topics have been widely studied as separate issues, the possible existence of a direct link between the two demands more attention.
Methods: An observational study encompassed data from 30 (EU28, Norway, Switzerland) European countries covering the years 1994 – 2013 and included annual standardized death rates due to intentional self-harm (X60-X84, ICD-10AM) and ischaemic heart disease (I20-I25, ICD-10AM).
Results: The correlation coefficient between suicide and ischaemic heart disease incidence rates revealed a statistically significant positive correlation in 21 countries: 9 – very strong; 8 – strong and 4 – moderate. The same correlation analysis amongst men alone revealed a statistically significant positive correlation in 22 countries: 8 – very strong; 8 – strong and 6 – moderate. The analysis amongst women alone showed a statistically significant positive correlation in 19 countries: 6 – very strong; 8 – strong and 5 – moderate. Only in Portugal and Cyprus did suicides and ischaemic heart disease correlate negatively, this correlation was statistically significant and also presented in males when analysed separately. By contrast, such a strong positive correlation was not found between death rates due to suicide and other heart diseases (I30-I51, ICD-10AM).
Conclusions: Our study confirms that there is a strong link between ischaemic heart disease and suicides in European countries. We hypothesise that our findings potentially show that more stressogenic environment is associated with more frequent cardiac events. This correlation is also statistically significant and strong when analysed separately by gender. However, this does not confirm there being a clear causal relationship between the suicidal behaviour and cardiovascular diseases. Moreover, this was an observational study and there is a possibility of many confounding factors and the presented causal relationship should be considered critically.