Summary: As the prevalence of cardiovascular disease (CVD) continues to rise, employers are looking for ways to better support employees and combat spiraling healthcare costs. The connection between the heart and the mind demonstrates the importance of expanding CVD strategies to include mental health support, including specialized, evidence-based digital mental health support for people with heart disease and related conditions. For employers, mental health and heart disease are closely linked and are most effective to address through an integrated health strategy that supports workplace well-being. This integrated view helps HR and benefits leaders quickly see why connecting mental and physical health support belongs in their overall workforce well-being approach.
The cost burden of cardiovascular disease on employers is huge and expected to get worse
The cost burden of CVD on employers is enormous and expected to get worse. According to the Business Group on Health, 40% of large employers say that cardiovascular conditions are their number three cost driver today, just behind cancer and musculoskeletal conditions. For many organizations, this makes cardiovascular and mental health an integrated health strategy priority rather than a standalone benefit.
Of course, direct medical costs aren’t the only source of employers’ CVD cost burden. For US employees with high cardiovascular risk, cardiovascular events and related procedures are associated with significant indirect costs due to lost productivity, including workplace absenteeism and short-term disability. In practical terms, this means heart-related health issues can show up as missed workdays, lower productivity, and higher disability claims across your workforce.
Without policy changes or efforts to prevent CVD, both direct and indirect CVD costs will continue to grow, increasing the employer burden. Between 2010 and 2030, the real, total, direct medical costs of hypertension, coronary heart disease, heart failure, stroke, and all other CVD are projected to triple, from $273 billion to $818 billion. Indirect costs due to lost productivity related to CVD are expected to increase 61%, from $170 billion in 2010 to $276 billion in 2030. These long-term trends reinforce the value of prevention and early intervention programs as part of a thoughtful employer health strategy.
CVD prevalence is high, and Black people are disproportionately affected
The cost trajectory isn’t surprising when you consider the prevalence of CVD: By 2030, 40.5% of the US population is projected to have some form of CVD. Cardiovascular disease is the number one killer of women, causing 33% of deaths each year, and the number one killer of new mothers. Alarmingly, almost half of women ages 20+ are living with some form of cardiovascular disease. For employers, this means a significant portion of the workforce is managing heart disease or elevated cardiovascular risk, with major implications for workplace well-being programs.
What’s more, health disparities and inequities exacerbate the risks of CVD, with CVD-related conditions disproportionately affecting people who are Black. Here are some examples:
- Hypertension—a major risk factor for heart failure, coronary artery disease, stroke, and other types of CVD—affects 56% of non-Hispanic Black adults in the US, more than non-Hispanic Asian adults (46%), non-Hispanic adults (48%), and Hispanic adults (39%).
- Black women are at highest risk for stress-related conditions such as hypertension, followed by Black men.
- Rates of hypertensive disorders of pregnancy are increasing, with Black women having the highest risk.
Understanding these disparities can help employers design more equitable benefits, targeted outreach, and culturally responsive mental health and heart disease support.
Recommended actions for employers to address hypertension and CVD risk
To address the hypertension risk, the National Alliance of Healthcare Purchaser Coalitions recommends the following action steps for employers:
- Know your data. Assess the prevalence, healthcare, and productivity costs of hypertension in your employee population. You can use the Alliance’s Claims Analysis Guide and Budget Impact Model to help.
- Make sure your plan covers certified home blood pressure monitors for employees diagnosed with hypertension.
- Conduct blood pressure screenings for employees at health-related and other work events.
- Partner with vendors that can address hypertension and help measure outcomes.
- Educate your workforce on preventative care for hypertension, CVD, and other chronic conditions.
Traditionally, preventative care for hypertension and CVD has focused on physical health behaviors, such as reducing salt intake, exercising regularly, maintaining a healthy weight, limiting alcohol consumption, and avoiding tobacco products. But research shows that mental health plays an important role in heart health, suggesting that many efforts to prevent CVD are incomplete.
The mind affects the heart, and the heart affects the mind
Indeed, the heart and the head have a complex, multifaceted relationship. Research has revealed these facts:
- A person experiencing persistent stress, anxiety, depression, or post-traumatic stress disorder (PTSD) may also experience physiological effects in the body, such as high blood pressure, increased heart rate, and reduced blood flow to the heart. These effects can lead to calcium buildup in the arteries, metabolic disease, and heart disease.
- At the same time, anxiety, depression and other mental health challenges may increase a person’s likelihood of adopting unhealthy behaviors, such as smoking or failing to take prescribed medications, which can also increase their risk of heart disease.
- What’s more, a cardiac event such as a heart failure, stroke or heart attack can cause fear, pain, and other responses that can bring on mental health disorders, such as depression, anxiety, and PTSD.
In other words, mental health can influence heart health, and cardiac events can, in turn, affect an employee’s emotional well-being and functioning at work.
Employees facing workplace discrimination are at higher risk of hypertension and heart conditions
A study about US workers in the Journal of American Heart Association showed that a person who reported high levels of discrimination against at work has a higher risk of developing hypertension than employees who reported low levels of discrimination. The study defined “workplace discrimination” as unfair conditions or unpleasant treatment due to race, sex, or age. Participants who reported high workplace discrimination exposure were 54% more likely to report high blood pressure later.
This link between workplace experience and cardiovascular risk underscores why inclusive culture, psychological safety, and workplace well-being initiatives are essential parts of employer heart health strategies.
Steps employers can take to incorporate mental health into their CVD strategies
It follows that employers aiming to address CVD and control healthcare costs have an opportunity to incorporate a strong focus on employee mental health in their strategies. In addition to smoking-cessation programs, nutritious food options, and coverage for home monitoring and medications, employers can implement a variety of measures to promote workforce mental well-being.
When framed as a single integrated health strategy that addresses both mental health and heart disease, these actions can strengthen workplace well-being and help manage overall healthcare costs. The list below gives HR and benefits leaders specific levers they can pull to bring mental health into cardiovascular disease strategies. Here are some steps employers can take:
- Recommit to establishing fair and inclusive workplaces using antidiscrimination policies and interventions.
- Offer flexible work hours.
- Help employees establish healthy work–life boundaries.
- Foster an environment that values taking mental health breaks.
- Offer mindfulness and mental health resources to support employees with stress, anxiety, depression, and other concerns, and to help them build resilience.
Specialized evidence-based support for employees with heart disease
Beyond these measures, employers can offer specialized, evidence-based, digital mental health support to employees and their family members whohave heart disease as part of a coordinated mental health and heart disease support strategy.
Living with Heart Disease: A Guide for How to Thrive is an evidence-based program in the Calm Health app that helps to support users with depression and anxiety, unwind from stress, and feel empowered to navigate the challenges of life with heart disease.
Developed by licensed clinical psychologist Dr. Alise Conner, the eleven-session program uses techniques drawn from cognitive behavioral therapy and acceptance and commitment therapy approaches. Listeners are taught techniques to relax quickly and shape their feelings, thoughts, and behaviors, to support the individual’s mental and physical health. For employers, programs like this can complement traditional disease management and wellness offerings by giving employees accessible tools they can use between medical visits.
The tools offered in the program may be relevant to other heart conditions, including the larger family of CVD, such as stroke, heart failure, valve disease, and heart rhythm disorders, and can be accessed immediately. This type of digital resource can fit naturally into an integrated health strategy that supports employees and covered family members living with heart disease.
A strategic approach to employee mental health and well-being
Nearly 80% of large employers (79%) are making mental health access a top priority in 2025, according to the Business Group on Health. They’re working to expand employee access to virtual and onsite counseling and eliminate out-of-network barriers to care. Many are also evolving toward an integrated health strategy that brings together mental health support, heart disease care, and broader workplace well-being initiatives.
But employers also have an opportunity to connect mental health support to cardiovascular disease, diabetes, cancer, and other chronic conditions that are increasingly prevalent among workforces and driving up healthcare costs. As research increasingly uncovers the intricate mind–body connection, the need to bridge the gap between mental and physical health care will continue to become clearer.
Embedding mental health and heart disease support into a unified benefits design can help organizations care for whole-person health while managing rising costs. For HR, people leaders, and benefits teams, this means regularly asking how every major health initiative—from CVD management to cancer care—can also advance workplace well-being and mental health.
