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Focus: The Depression/Heart Disease Link

separator Emotional well-being and physical health seem to be linked in many ways, and heart disease is no different. A study published in a well-known European cardiology journal has shown that from a sampling of 17,541 men and women older than 40 who had some form of heart disease:

  • 4.1 percent of those reporting psychological distress had coronary artery disease
  • 6.4 percent reporting psychological distress had a history of heart attack
  • 10 percent reporting psychological distress had heart failure

Researchers used these numbers and determined that it’s likely that more than 1 million Americans with a history of heart disease are suffering from depression.

Depression associated with poorer outcomes
Besides the simple fact that suffering from some type of emotional problem is difficult, it’s been known for years that heart patients who do suffer from depression have poorer outcomes, including increased mortality, in the months after a heart attack. And depression itself is under-treated. Research shows that only about one third of Americans who have depression receive a referral to a mental health professional.

A new study in the Archives of Internal Medicine has shed some light on why depression increases mortality in heart patients. Researchers have discovered that heart patients who are experiencing depression have what’s called a “low heart rate variability.” Heart rate variability is what allows your heart to change its rate depending on the level of demand. In other words, when your heart rate variability is low, your heart doesn’t respond as quickly as it should.

Lower heart rate variability has been linked to higher death rate in heart patients, but this is the first time that researchers have so clearly identified a link between heart patients, depression and HRV.

Who’s most at risk for depression?
Research indicates that members of the population most at risk for depression include

  • Being female, Hispanic or African-American
  • Being obese
  • Being inactive
  • Having less than a high school education
  • Smoking

Symptoms of depression
Symptoms of depression include:

  • Feelings of sadness or emptiness
  • Lack of interest in activities that used to be pleasurable, including sexual activity
  • Decreased energy
  • Difficulty sleeping or oversleeping
  • Change in appetite and weight
  • Irritability
  • Thoughts of suicide

Researchers are suggesting that people with heart disease should get screening for depression. But you don’t have to wait for your doctor to screen you. If you’re a heart patient and you have some of the symptoms of depression, be sure to talk to your doctor about it. Depression is highly treatable, and with everything we now know about depression and your health, there’s a real possibility that the treatment could save your life.

Archives of Internal Medicine, July 2005; European Heart Journal, June 2005; National Institute of Mental Health
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