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Depression may Cause Heart Disease and Related
Death
Previous research has already suggested that there a two-directional
link between depression and health conditions of the heart. |
A recent study published
in the Journal of the American College of Cardiology has added to
the body of evidence, having found that being depressed could increase
the likelihood that a person gets hit or killed by heart disease.
Details of Study
The study team, comprising members from the Columbia University Medical
Center in New York, University of California, Berkeley, Harvard Medical
School in Boston, as well as the Harvard School of Public Health in
Boston, had followed 63,469 women who were part of the Nurses' Health
Study; the study subjects were free from cardiovascular disease at the
start of the exercise.
Questionnaires were used in 1992, 1996 and 2000 to obtain information on
symptoms of depression, while data on antidepressant use was collected
in 1996 and 2000. Outcomes looked at were sudden cardiac death, fatal
coronary heart disease, and nonfatal myocardial infarction.
Findings of Study
The Mental Health Index (MHI-5) was used to assess the women's symptoms
in 1992, and the scale predicted that 7.9% of them had clinical
depression. The researchers also found that symptoms of depression were
associated with events of coronary heart disease. After controlling for
other risk factors for the condition, it was found that those with such
symptoms had 49% higher risk of fatal coronary heart disease.
In post-1996 models, the study team used a proxy variable for clinical
depression, which consisted of severe depressive symptoms and / or the
use of antidepressants, and they found that depressed women had 133%
higher risk of sudden cardiac death. This risk could be mainly
attributed to the relationship between the use of antidepressants and
sudden cardiac death (234% higher risk).
The latter finding is somewhat of a surprise. There are two main
possibilities for it - that the use of antidepressants was indicative of
women who suffered the worst bouts of depression, which would make
sense, or that antidepressants could themselves be contributing to heart
problems, which would be bad news. This is especially since
antidepressants already have a number of other known side effects. More
research into this area will be needed.
William Whang, MD, the leader of the study, said that his team's
findings add to growing research which shows depression as an
independent risk factor for cardiovascular disease, on top of already
well-established ones like smoking, hypertension and unhealthy
cholesterol levels. And, in fact, the Nurses' Health Study, which
covered mainly white females, may understate the risk. "If anything, the
impact in African-American women is probably greater," he said.
According to him, future research should check out whether proper
treatment of depression would lower the risk of negative heart outcomes.
Other Research
The same applies to males too, according to a study recently presented
at the American Psychosomatic Society's annual meeting. In that study,
information on over 1,200 male twins who had been in the US military
during the Vietnam War was used. The men were surveyed on various health
issues, including depression, in 1992 and then again in 2005. The
researchers found that men who were depressed in 1992 had twice the risk
of getting heart disease in the following years, as compared to those
who did not suffer from the condition.
Jeffrey F Scherrer, PhD, a research assistant professor of psychiatry at
the Washington University School of Medicine and the St. Louis Veterans
Affairs Medical Center, summed up his team's research when he said:
"Based on our findings, we can say that after adjusting for other risk
factors, depression remains a significant predictor of heart disease."
The Depression-Heart Disease Link
After suffering a serious ailment like a heart attack or a stroke, it is
easy to slump into a period of depression. This is especially so if the
patient is required to make certain drastic changes to his lifestyle and
dietary habits. No more smoking, drinking, or eating their favorite
foods, for example. Some may even suffer from loss of vital bodily
functions, due to partial or full paralysis. Under such circumstances,
it is natural to feel down.
But how does depression affect heart health? In the first study, it had
been discovered that women who had worse symptoms of depression had a
higher likelihood of also having other risk factors for heart disease.
In addition, emotional stressors such as depression could cause elevated
resting heart rates, making the heart work harder.
Further, depressed persons are more likely to neglect their own health
and wellbeing. This may include not eating properly, failing to
exercise, and not resting well.
And we cannot rule out the possibility of a vicious cycle taking place,
whereby heart disease patients fall into depressive states and then
become more likely to suffer worsening heart outcomes. It is thus very
important that the depression-heart health link be taken seriously.
Indeed, the American Heart Association had recently made the
recommendation that persons who suffer from heart disease undergo
regular checks for depression. This is something which you and your
loved ones should take note of, and heart patients should be carefully
observed for any possible symptoms of depression.
References
Whang W et al. Depression and Risk of Sudden Cardiac Death and Coronary
Heart Disease in Women. Journal of the American College of Cardiology
2009;53:950-958. |
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