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Depression Linked To Heart Disease
It’s a common fact that after a heart attack, depression may follow and that it can worsen the outcome of heart patients’ recovery.
Now, US researchers from the University of Columbia reported new evidence that depression can lead to heart disease in the first place.
Broken hearts
In 2007 a 6-year study of 360 depressed patients who also had a history of heart attack, showed that the patients who did not recover from their depression in the first six months were more than twice as likely to die. At this time, Dr. Alexander Glassman Professor of Psychiatry at Columbia University had this to say about the evidence of this study: "There is an unequivocal link between depression and heart disease, but it is not clear what causes this link."
The latest research from the University of Columbia comes from a 12-year study, Nurses' Health Study, which followed 63,000 women between 1992 and 2004. None had signs of heart disease when the study began, but nearly 8 per cent had evidence of serious depression.
The study, published in the Journal of the American College of Cardiology, concluded that the depressed women were more than twice as likely to experience sudden cardiac death — death typically caused by an irregular heartbeat. They also had a smaller increased risk of death from other forms of heart disease.
Independent risk factor
Here’s the big knock-out...
According to the Nurses’ Health Study, sudden cardiac death was more closely linked with antidepressant use than with the depression symptoms the women reported. Dr. William Whang, lead researcher said that this might simply mean that women who used antidepressants were, appropriately, the most seriously depressed.
Dr. Redford Williams of Duke University and a specialist in how psychosocial factors affect health, said that studies of the newer antidepressants most often used today, so far, haven't signalled a risk of irregular heartbeat, and some even have suggested a degree of protection.
The drug question aside, Dr. Williams said the study adds to growing evidence that depression is an independent risk factor for heart disease — on top of the classic risks of high blood pressure, diabetes, high cholesterol and smoking.
Why the link?
The study found that the more severe the women's reported depression symptoms, the more likely she was to have traditional heart risk factors. Also, stresses like depression have been linked to such physical effects as a higher resting heart rate.
Possible other reasons for this association include sticky platelets, a condition depressed patients are likely to have, or autonomic nervous activity, which increases heart irritability.
The brain also has significant control over the levels of inflammatory molecules called cytokines in other parts of the body, and these levels are altered in depression and associated with an increased risk for heart disease.
Stressful events early in life and the response to stress later in life can also play a role. These events could pave the way for either depression or heart disease and could potentially contribute to vulnerability for both conditions.
Perhaps a more straightforward reason: Depression can make people neglect themselves. Indeed, the American Heart Association last year recommended that everyone who already has heart disease be regularly screened for depression — because depressed patients may skip their medications, sit indoors instead of exercising, and eat particularly poorly.
It all adds up...
Sources:
‘Depression Linked To Heart Disease’ published online 10.03.09, cbsnews.com
‘Conditions & Diseases: Psychological & Mental Health’ published online, omnimedicalsearch.com
‘More proof depression hurts women’s hearts’ published online, 09.03.09, msnbc.msn.com
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