Depression increases the risk of heart failure in cardiac patients

Dr. Heidi May, epidemiological researcher at the Intermountain Medical Center (IMC), Utah said, "We found that there was a 50 percent increase in risk with patients with heart disease to develop heart failure."

Researchers recruited 13,700 patients from IMC that were diagnosed with a cardiac problem. Out of the total, nearly 10 percent, that is 1377 were engulfed by depression after the diagnosis.

The incidence of heart failure was found to increase two-fold in melancholy patients as compared to those who did not have depression. The risk was a little lower after taking into consideration cardiovascular factors such as hypertension and diabetes, but it was still 50 percent higher.

According to the study, the occurrence of heart failure among patients not suffering from despair after being diagnosed with cardiac disease was 3.6 per 100 compared with 16.4 per 100 for those with a post-heart disease depression diagnosis.

Analyzing the medical records of 7,719 participants, the researchers found no difference in the incidence of heart failure between people prescribed antidepressants and those not prescribed the drugs. Rather it was established that antidepressants may not be able to change the risks of heart failure even when the drugs reduce the symptoms of the depression.

"I was surprised about that," May said. "Since antidepressants reduce the symptoms of depression, you would think that they would decrease the risk of heart failure."

Dr May further added "Our findings indicate that it may be important for clinicians to keep in mind that although a patient's depressive symptoms may improve, the risk for harmful cardiovascular outcomes related to depression might not."

The study highlights that depression is a vital and an emerging risk factor for heart failure among patients with coronary heart disease. Many patients feel dejected, insecure and helpless, feelings that spiral into clinical depression. There is an urgent need to understand the co-relation between the two disorders and what clinicians should do to help their patients.

"Patients need to be carefully screened for depression so that interventions that alter some of the risk associated with depression can be used and the related risk of heart failure and other cardiovascular events can be diminished," stated May.

Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University, stated, "But the study leaves open the possibility that other interventions, such as behavioral therapy, might have an effect. That is pure speculation on my part. But cognitive behavioral therapy, which teaches patients coping skills to deal with negative thoughts, might be effective."

A report on the findings is published in issue of the Journal of the American College of Cardiology.