The Connection Between Depression and Heart Disease

Recent studies show heart attack victims have a greater chance of suffering from depression and depressed people are more likely to have heart attacks. In the United States, heart disease is the leading cause of death, and depression is the most common reason for disability. Besides taking cholesterol and blood pressure medications like Caduet to prevent heart attacks and strokes, you also may need depression treatment.

When Heart Disease Causes Depression

Research has linked depression with heart failure, which increases morbidity and mortality. Depressed heart failure patients have increased physical symptoms, hospitalizations, financial burdens and decreased quality of life. Just one week after cardiopulmonary bypass surgery, nearly half of study patients in one investigation experienced serious cognitive problems, which may contribute to clinical depression in some people. Multiple studies report that moderate to severe post-op depression can interfere with your recovery and increase your risk of developing additional cardiac complications. Depression after cardiac surgery causes sedentary behavior, and post-op inactivity increases patients’ depression risk substantially. Fifty percent of people with no history of depression develop symptoms after a heart attack, and 20 percent undergo major depression. This increases their risk of having another heart attack or dying within months or years. Being hard on yourself for not taking care of your health may bring you down. Alternatively, the grim reminder of your own mortality can tank your spirits. These feelings are normal when they’re temporary, but if they persist beyond a few weeks, you may be suffering from clinical depression.

How Depression Became a Heart Disease Risk Factor

The American Heart Association convened an expert panel to determine the link between heart disease and depression. After reviewing 53 studies extensively, investigators reported approximately 20 percent of all patients with acute coronary syndrome (ACS), myocardial infarction (MI) and unstable angina also met clinical criteria for major depression, and many more had depressive symptoms. Most studies show that depression predicts heart problems or mortality. The group recommended elevating depression to the status of a heart disease risk factor.

If Depression Precedes Heart Disease

Research shows that people with depression, without previously detected heart disease, usually develop heart disease at a higher rate than the general population. Depressed people are more likely to smoke, drink excessive amounts of alcohol and avoid exercise. The mental stress that comes with depression may increase plaque formation in arteries. Depression can increase the production of free radicals and fatty acids, damaging blood vessel linings. While studying 880 adults, the University of Maryland School of Medicine found depressed people have higher C-reactive levels. Research links the C-reactive blood protein to heart and blood vessel inflammation. This increases the production of collagen, the fibrous protein that connects your skin, bones, tendons and muscles. Too much collagen causes fibrosis, which stiffens your heart so it can’t flex and pump blood as it should. A of 1551 people without heart disease found those with a history of depression were four times more likely to suffer a heart attack in the next 14 years. Other researchers reported that depressed heart patients were four times as likely to die in the next six months. Harvard mental health research shows depressed patients who end up in the hospital for heart attacks are two to four times more likely to die within a year.

Distressed Personality Causes Heart Disease

Multiple studies indicate psychological distress may cause rapid heartbeat, high blood pressure, faster blood clotting and elevated cholesterol levels. Because depression, stress and anxiety coexist often, scientists classified these behaviors as a Type-D (or distressed) personality. You may function more slowly even while depression elevates your cortisol and adrenaline stress hormone levels. This activates your fight or flight response which can increase your heart’s workload and take a toll on your body. Distress diverts your metabolism away from repairing damaged heart disease tissue.

Why Depression and Heart Disease Coexist in the Elderly

Studies indicate the elderly are most apt to suffer from depression linked to heart disease. Sadly, they’re the least likely to seek depression treatment. Nineteen to 30 percent of people 65 and older experience signs of depression. Women are generally more depressed than men, and people living alone are more prone to depression. A Wake Forest University study of 4,500 elderly participants with no history of heart disease found those who showed signs of depression had a 40 percent higher risk of developing coronary disease.

Physical and Mental Treatments

Regardless of which condition caused the other, research associates the combination of depression and heart disease with increased illness and death. You may need both prescription heart medications and antidepressants. If necessary, cognitive-behavioral therapy also can reduce the adverse affects of clinical depression.

Step up Your Fitness Activity

Exercise is a useful tool to manage both depression and heart disease. A major depression study found that exercise-training programs improved depressive symptoms in older adults comparable to selective serotonin reuptake inhibitors. Physical activity also strengthens your heart and cardiovascular system. It can reduce heart disease risk factors including high blood pressure and being overweight. Exercise also enhances circulation, helps your body use oxygen better and improves heart failure symptoms. If you’re out of shape, start with short walks and increase your physical activity gradually.

Be Proactive About Your Health

Cardiologists tend to miss the coexisting diagnosis of depression. Untreated depression can make you less likely to take your necessary heart medications and follow a healthy lifestyle. If you have signs of depression, schedule a screening and seek treatment.