A new study found that people with high levels of stress and depression are more likely to die or experience heart attack.

Researchers at Columbia University Medical Center examined the effect of high stress levels and severe depression in about 5,000 participants aged 45 and older. The participants agreed to in-home examinations and completed questionnaires aiming to measure their depression and stress levels. They were asked if they felt depressed, lonely or sad, and if they were able to take control of their lives and handle personal problems during the past week.

The analysis showed that 12 percent of the participants experienced high stress, 14 percent had high levels of depression, and 6 percent suffered from "psychological perfect storm" or a combination of high levels of stress and depression.

The researchers concluded that those with high levels of stress and depression were 48 percent more likely to die or experience heart attack compared to those who were less stressed and less depressed.

"The increase in risk accompanying high stress and high depressive symptoms was robust and consistent across demographics, medical history, medication use and health risk behaviors," Carmela Alcántara, lead author of the study and associate research scientist at Columbia University Medical Center for Behavioral Cardiovascular Health, said in a news release.

So why is the risk higher during a psychological perfect storm?

"During periods of stress, the part of the nervous system that regulate the heart and other organs makes the heart beat harder and faster-causing blood pressure to increase, a potential cause of heart attacks and strokes," Dr. Phil Chowienczyk, who was not part of the Circulation study, wrote in an email to Reuters Health.

The findings of the study will be useful in improving current stress management programs and behavioral interventions.

The study was published in the March 10 issue of the journal Circulation: Cardiovascular Quality and Outcomes.