Cardiac disease linked to depression

There are a number of issues that are considered risk factors for cardiac disease, that is, they increase the risk that someone may develop a heart attack. Some can be controlled or modified, others cannot.

Since cardiac disease is the number one cause of mortality in the US, it’s important to look at these factors and work to decrease or modify those that can increase the threat of cardiovascular disease.

In the past, all of those risk factors have been physical ones (age, hypertension, smoking and others). A growing body of evidence indicates that there may be at least one psychological factor to add to the equation: Depression.

There are some risk factors that cannot be modified. Givens such as genetics, age and gender are unalterable.

For example, some families have a history of developing heart disease that starts early. There may be family members who have heart attacks in their early 40s, 30s or even in their 20s.

Aging increases the risk for having a heart attack. Older people thus have a higher risk of cardiovascular disease.

Men are at risk to have heart attacks earlier than women. But risk in women begins to approximate that of men after women finish menopause.

There is not much that we can do about those listed above. However, we can focus on factors that can be controlled or modified to lower risk.

Modifiable risks of cardiac disease, including depression

Modifiable risk factors include things like: hypertension, diabetes, smoking, elevated blood lipids, obesity, lack of exercise and others. These things can be altered to help lower the chance of a cardiovascular event.

Diabetes can be controlled. Patients can stop smoking. Blood pressure can be managed. Blood lipids can be lowered. Additionally, other factors that may play a role can also be modified. Patients can eat a more healthful diet, lose weight, begin to exercise regularly and do other things to develop a more healthy lifestyle.

Broken heart by Shutterstock

Broken heart by Shutterstock

For decades, the American Heart Association (AHA) has sponsored research into and published information about cardiovascular diseases. They’ve compiled a list of some of the things that may lead to a heart attack. In a recent study, they looked at the possibility that there might be a psychological risk factor that could lead to heart attacks. That factor is depression.

There was some previous research that showed an increase in heart disease in patients who had concurrent depression. Some studies, dating back over 20 years, showed that some psychological factors could elevate the risk for a heart attack and/or increase the chance for a poorer outcome after someone had a heart attack.

The AHA convened a panel of experts in the field to review a large number of studies that looked at the role of depression in cardiovascular diseases. The panel reviewed a number of studies. Some had only 100+ research subjects, but others included studies that contained over 10,000 patients. Some of these patient populations were followed for years to see whether or not they developed cardiovascular diseases. The research was done in Europe, Asia and the US.

Essentially, what these, and some of the other studies showed, was that depression is correlated with the risk of having a heart attack. People who have a heart attack and are depressed have worse outcomes than patients who have heart attacks and are not depressed.

The recommendation of the committee is that the AHA include depression as a risk factor for cardiovascular disease.

In addition to the previously cited physical risk factors (blood lipids, hypertension, etc.) we also need to look at the psychological factors that may contribute, as well.


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Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • The_Fixer

    >Clink!<

  • Silver_Witch

    To a cure!!

  • The_Fixer

    A cure by 2020 or sooner? You ‘n me both, sweetie :)

    Seriously, we’ve known for a long time that depression is a serious disease and it affects people in profound ways. To someone who has never experienced it, they don’t understand that it’s far more serious than just “feeling a little down” – it completely colors one’s world in a profound way. I also think it’s tremendously under-diagnosed, to tell you the truth.

    Regardless of all of that, let’s hope that they do come up with a cure, the sooner the better.

  • Jay

    Good article – Thnx

  • cambridgemac

    With me it’s cold hands and fatigue…A day or two before the cold. I’ll start observing to see if negativity is there as well.

  • Silver_Witch

    You know Fixer, I never thought of that – I though mean people (you know grumpy, grouching, generally being disagreeable) would lead to so much stress it would cause early death – but I guess it is we they stress and not themselves.

    Depression is harsh, the medication is often even harsher…here is to finding a real cure in 2020 (I just randomly picked that date – sooner would be great too.)

  • http://www.oneutah.org Glenden Brown

    This information makes sense to me. I would be so bold as to suggest that depression is also correlated with worse overall physical health in general. Depression makes it more difficult to eat right, exercise and otherwise take care of yourself. Those lifestyle factors contribute to heart disease.
    The outcomes after a heart attack would also suffer as a result of depression – again connected to the ways in which depression makes correct self care more difficult.
    I hesitate to over share but I’m going to risk it. When I’m in the grip of depression, my physical and mental health both suffer. It’s not uncommon for me to binge eat, then go for a day or two without eating, to be so exhausted the thought of putting on exercise clothes exhausts me. What’s more, I also experience severe digestive problems when I’m depressed and I’ll eat way doesn’t upset my stomach which is often high fat foods. I don’t like it, it’s not as if I’m trying to eat crap, but given a choice between an awful, constant stomach ache and nausea or not, what would you choose? (I also realize I’m a little defensive because there is still a stigma in many parts of society toward those who suffer any form of mental illness.)
    The mind-body connection is a powerful thing.

  • The_Fixer

    Oh, I know that, in my case at least, when I’m depressed, I have the classic physical symptoms. Lack of energy, aching, that kind of thing.

    I think the meanest living the longest is a result of having no empathy. They’re not troubled by what others are experiencing, so they have no stress. Conversely, you’ll also find people who live to be a ripe old age because they are basically happy, and can deal with bad thoughts and negativity. It’s not like the basically happy people are unsympathetic, it’s just that they can compartmentalize bad news and bad things happening in their lives.

    Some of us have the capacity to deal with adversity either by ignoring it or dealing with it productively. Then there are those of us who are not gifted with the ability to “blow off” the bad stuff.

    To the point of the article: yes, I think that depression can and does cause various physical problems. I think we’ve all heard stories of surviving spouses/partners “dying of a broken heart” after the death of their beloved. This information certainly provides a basis for explaining that.

  • SFExPat

    Smiles and hoo-rahs to you, S_W!!

  • Silver_Witch

    Oh believe me I seize the day, every day. Life is too beautiful!

  • http://AMERICAblog.com/ John Aravosis

    That’s funny, with me it’s fatigue. I just feel incredibly worn-down that day – I’ve learned to recognize the symptom and get a good night’s sleep if I’m feeling that way.

  • SFExPat

    Silver_Witch, we are ALL dead people walking. No one here gets out alive.
    Seize the day!

  • Silver_Witch

    That is so funny – when I stuff something I really need to say to someone I get this weird cough – in my chest….

    I totally believe in our thoughts affecting our health status. Yet, often it seems, it is the meanest that live to be the oldest.

  • http://musephotos.wordpress.com/ GarySFBCN

    Interesting. One early symptom that indicates I’m about to have a cold or the flu is negativity. Regardless of my web-persona, I’m a very optimistic and ‘up’ person, and I don’t usually get involved in needless drama.

    So when I start having negative thoughts, etc, sure enough a cold will follow, usually within 4-5 hours.

  • Silver_Witch

    Oh Goddess – I am a dead woman walking.

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