Objective: This study assessed the impact of depressive symptoms and distress from patient problem behaviors on time to developing a diagnosis of cardiovascular disease (CVD) in a sample of 643 dementia family caregivers. Design: A longitudinal, prospective design was used. Over an 18-month period, caregivers free from a CVD diagnosis at baseline were assessed at 6, 12, and 18-month follow-ups for the onset of CVD. Main Outcome Measures: Days to the onset of CVD was the primary outcome. Results: Over the length of the study, 32 participants (5%) reported a diagnosis of CVD. After adjusting for sociodemographic and health factors (e.g., high blood pressure, age, smoking history), greater depressive symptoms ( p = .040) and distress from patient problem behaviors ( p = .034) were significant predictors of time to CVD diagnosis. Conclusion: This study suggests that increased depressive symptoms and reaction to patient problem behaviors (i.e., distress) may increase caregivers' risk for experiencing negative health outcomes, specifically CVD.