Having a mental illness when you’re in your 20s or 30s puts you at a higher risk of a heart attack or stroke later in life according to a new landmark study. 

The study, published in the European Journal of Preventive Cardiology, found that young adults who have gone through mental health disorders are at three times the risk of a heart attack or stroke. Using the Korean National Health Insurance Service (NHIS) database, which contains information about the entire population of Korea, researchers studied ~6.5 million adults aged between 20 and 39 years until December 2018. 

Approximately 13% of the participants, that’s 1 in 8 people, had anxiety, depression, bipolar disorder, and other mental disorders. The results revealed that participants with mental disorders had a 58% chance of undergoing a heart attack while the risk of stroke stood at 42%. 

Of the 13% of participants with mental disorders, 47.9% lived with anxiety, 21.2% had depression, and 20.2% had insomnia. At least 27.9% of the participants lived with some form of psychosomatic disorder, where people experience physical symptoms like pain or gastrointestinal issues.

“Psychological problems were common in young adults and had strong links with cardiovascular health. The findings indicate that these individuals should receive regular health check-ups and medication if appropriate to prevent myocardial infarction and stroke,” said the study’s author, Professor Eue-Keun Choi of Seoul National University College of Medicine.

However, Choi cautions that lifestyle behaviors alone might not be the cause of this elevated cardiovascular risk. On the other hand, healthier habits could also reduce risk and young adults must be encouraged to improve their lifestyles for better heart health. 

“For example, if you are chronically depressed, you may struggle to maintain a healthy diet and get adequate physical activity, which might in turn increase your risk for cardiac events over time,” says Dr. Katherine Ehrlich, an Associate Professor of behavioral and brain sciences at the University of Georgia to CNN.