Veterans with specific mental health disorders—depression , psychosis and bipolar disorder—had an increased risk of heart attack, stroke and death from cardiovascular disease, according to new research published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

The link between mental illness and cardiovascular disease is well established. However, there has been little research and data on which mental health conditions pose the highest risk for cardiovascular disease.

In this study, researchers assessed veterans at risk for major heart disease and stroke events and death associated with depression, anxiety, PTSD, psychosis and bipolar disorder. The analysis included data from more than 1.6 million veterans ages 45 to 80 who received care in the Department of Veterans Affairs healthcare system from 2010-2014. About 45% of the men and 63% of the women had been diagnosed with a mental health disorder.

When controlling for age, cardiovascular risk factors such as blood pressure and cholesterol, other mental health conditions and psychiatric medications, both men and women with various mental health diagnoses except post-traumatic stress disorder had a higher risk of cardiovascular events and death over five years. Additional findings from this study:

In particular, among men, depression, anxiety, psychosis and bipolar disorder were associated with an increased risk of death from cardiovascular disease. And, depression, psychosis and bipolar disorder were also linked to cardiovascular events such as heart attack and stroke.

Among women, depression, psychosis and bipolar disorder posed a higher cardiovascular disease risk. Psychosis and bipolar disorder also increased the risk of death.