Depression and Your Heart

Posted: Feb. 1, 2005

Research over the past two decades has shown that depression and heart disease are common companions and each can lead to the other.

It appears that depression is an important risk factor for heart disease along with high blood cholesterol and high blood pressure. A study conducted in Baltimore found that of 1,551 people who were free of heart disease, those who had a history of depression were four times more likely than those who did not to suffer a heart attack in the next 14 years.

How depression affects the heart
Psychological distress may cause rapid heartbeat, high blood pressure and faster blood clotting. It can also lead to elevated insulin and cholesterol levels.

Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Depression also may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline, and the activation of the "fight or flight" response, which can have deleterious effects on the heart.

The first studies of heart disease and depression found that people with heart disease were more likely to suffer from depression than otherwise healthy people. While about 1 in 20 American adults experience major depression in a given year, the number goes to about one in three for people who have survived a heart attack.

Treatment of depression
Researchers have found that most heart patients with depression do not receive appropriate treatment. Cardiologists and primary care physicians tend to miss the diagnosis of depression; and even when they do recognize it, they often do not treat it adequately.

Regardless of cause, the combination of depression and heart disease is associated with increased sickness and death, making effective treatment of depression imperative.

With the advent of the selective serotonin reuptake inhibitors (SSRIs) to treat depression, more patients can take these medications, which do not have the complicating cardiovascular side effects of the previous drugs available.

Exercise is another potential pathway to reducing both depression and risk of heart disease.

Source: National Institute of Mental Health

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