How is depression linked to heart disease?

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"While not experienced by all patients, becoming depressed after surgery is a fairly common event. Depression following hospitalization and cardiac surgery has been linked to the development of new cardiac complications. Based on our research findings, we can offer some common-sense approaches to combat depression." - Janey Peterson, RN, MA

  • Be aware: Left untreated, depression can become a serious health problem. You and your caregivers should be mindful of changes in mood and realize that you may become depressed after the operation.
  • Don't forget social support: We see many patients who become cut off from their social networks—bridge clubs, book groups, and golfing partners—once they have surgery. It's important not to close yourself off from people after you go home. These relationships area valuable way to maintain quality of life.
  • Confidence is key: Patients who do the best after surgery are those who have a good attitude. You had major surgery for a reason: to improve and extend your life. Patients who become proactive and "seize the moment" resume a high quality of life after their operation.
  • Get professional help: We encourage our patients to seek out help for depression. Often, pharmacologic treatment can be provided by your internist or cardiologist. However, treatment can also be provided by a mental health professional.

Depression is common in people who suffer from heart disease.

  • About 18 to 20 percent of coronary heart disease patients without a history of heart attack experience depression.
  • A significant percentage (40 to 65 percent) of coronary heart disease patients with a history of myocardial infarction (heart attack) experience depression.

Depression in heart disease patients is dangerous for a variety of reasons:

  • The symptoms of depression may be disabling and can worsen the symptoms of heart disease.
  • Depressed cardiac patients may be less prone to follow and adhere to cardiac treatment regimens.
  • People who survive heart attacks but suffer from major depression have a three to four times greater risk of dying within six months than people who do not suffer from depression.

Although often co-occurring with heart disease, clinical depression is not an expected result of heart disease. When present, clinical depression should always be treated.

Depression may affect you in many ways throughout your recovery from heart surgery:

  • Appetite: You may eat too much or too little.
  • Sleep: You may oversleep or not be able to sleep.
  • Emotions: You may find yourself crying for no reason.

The relationship between depression and heart disease is a two-way street. A review article reported that depression roughly doubles your risk of developing coronary artery disease. Other studies show that people who already have heart disease are three times as likely to be depressed as other people. As many as one in five heart attack survivors develops depression. And depression is an independent risk factor for a subsequent heart attack in people who've already had one. This may be in part because people who are depressed are less likely to take proper care of themselves—by quitting smoking, taking medications, or exercising—even after a heart attack.

It has been shown that as many as 30-40% of cardiac patients experience clinically important depressive symptoms. Major depressive disorder is present in as many as 20% of patients with cardiovascular disease and is associated with adverse cardiovascular outcomes, even after controlling for other risk factors.

Depression is related to the onset of cardiac disease, and is associated with higher medical costs, reduction in patients' quality of life and triple the risk of non-adherence with medical treatment regimens. In fact, cardiovascular prognosis is linked to the severity of depressive symptoms. Risk increases along with symptom severity whether or not the patient meets diagnostic criteria for a depressive disorder.

Depression reduces the chances of successful modification of cardiac risk factors and participation in cardiac rehabilitation, and is associated with higher health care utilization and costs and greatly reduced quality of life.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.