Thursday, 28 March, 2024
HomeCardiologyStress and depression increase heart risk

Stress and depression increase heart risk

Research has found the combination of stress and heavy depression can significantly increase heart patient's risk of death or heart attack. The study examined the effect of high stress levels and high depressive symptoms among nearly 5,000 heart patients. Researchers concluded that risk is amplified when both conditions are present, thus validating the concept of a "psychosocial perfect storm."

"The increase in risk accompanying high stress and high depressive symptoms was robust and consistent across demographics, medical history, medication use and health risk behaviours," said Dr Carmela Alcántara, lead author of the study and associate research scientist at Columbia University Medical Centre for Behavioural Cardiovascular Health in New York.

Study participants included 4,487 coronary heart disease patients, 45 years and older, enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. During in-home examinations and self-administered questionnaires from 2003-07, participants were asked how often during the past week they felt depressed, lonely or sad, or had crying spells. To determine stress levels, participants were asked how often during the past month they felt they were unable to control important things in their lives, felt overwhelmed, felt confidence in their ability to handle personal problems and felt things were going their way. About 6% reported both high stress and high depression.

During an average six-year follow-up, 1,337 deaths or heart attacks occurred. Short-term risk of death or heart attack increased 48% for those in the high stress-high depressive symptoms group compared with those in the low stress-low depressive symptoms group.

The elevated risk was most strongly associated with death rather than heart attack; additional result suggest the deaths may have been cardiovascular-related, but more research is needed, researchers said. The risk was significant only during the first two-and-half years from the initial home visit, and wasn't significant for those experiencing either high stress or high depressive symptoms alone, but not both at the same time.

Study findings may challenge traditional research paradigms that only focus on depression and its impact on patients with heart disease, Alcántara said. Behavioural interventions also should be considered to help heart disease patients manage both stress and depression better.

[link url="http://newsroom.heart.org/news/perfect-storm-of-stress-depression-may-raise-risk-of-death-heart-attack-for-heart-patients"]American Heart Association material[/link]
[link url="http://circoutcomes.ahajournals.org/content/early/2015/03/10/CIRCOUTCOMES.114.001180"]Circulation: Cardiovascular Quality and Outcomes abstract[/link]

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