A study of more than one million Swedish men finds those who had an alcohol use disorder in their late teens had a higher risk of heart disease over the next two decades than those without a drinking problem. Later hospitalization for substance use disorders was also associated with a higher heart disease risk.

The researchers found mental illness, including depression and schizophrenia, also was linked with an increased risk of heart disease, The Huffington Post reports.

“Our findings suggest that mental disorders pose a huge public health burden in terms of premature illness and death due to coronary heart disease,” study author Catharine Gale of the universities of Edinburgh and Southampton, said in a news release. “The physical health care of people with mental disorders needs to be a priority for clinicians if this burden is to be reduced.”

The men entered the study at an average age of 18, and were followed over a 22.6-year period. Those at highest risk for heart disease tended to be men whose mental conditions required hospital admission.

The findings appear in the journal Circulation.