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Depression and Heart Disease There has been evidence showing people with depression are more vulnerable to heart disease. Recent research has also found that some genes that raise the risk of heart disease could also make people more prone to depression. This points to the possibility that depression-heart disease link might be genetic. A twins study conducted by American researchers from Washington University and the Veterans Affairs Medical Center in St. Louis found that depression would almost double the risk of getting heart disease over 12 years. The findings were reported on March 4, 2009 at the American Psychosomatic Society meeting in Chicago. Twins can help determine how much genetics influences health since identical twins share 100 percent of their genes and fraternal twins have 50 percent of genes in common. The study involved both kinds of twins. More than 1,200 middle-aged men who aged between early 40s and mid-50s and had no heart disease at the start were tracked. After controlling some key factors like high blood pressure that could lead to heart disease, researchers found that depression can lead to the risk of heart disease just like what diabetes, high cholesterol or obesity can do. This study also indicated that we could not ignore the role of depression in heart disease by simply blaming all due to genetics.
In another study, researchers in England, Finland, France and the United States argued that patients who had depression and heart disease are almost 5 times as likely to die as people who are mentally and physically healthy. They examined data from about 6,000 middle-aged adults from the British Whitehall II study, which investigated the effect of social and economic factors on long-term health, and published the results online in September 2010 in the medical journal ‘Heart’. About 14.9 percent of the participants were found to score high on a test designed to determine whether they were depressed, and some 20 percent of participants with heart disease were determined to have depression, compared with 14 percent of those who had no heart disease. During the 5-and-a-half year study, 170 people died, with 47 of them died of heart attack or stroke. Patients with coronary heart disease alone were 67 percent more likely to die of any cause, and healthy people with depression were twice as likely to die as patients who had no depression or heart disease. Patients who had both depression and heart disease were almost 5 times as likely to die as people who were mentally and physically healthy. After adjusting for age, sex and other factors, the researchers found that the combination of depression and heart disease tripled the risk of death from all causes and quadrupled the risk of death from a stroke or heart attack. The study provided evidence that depression symptoms were linked to increased risk of all-cause and cardiovascular death and that the death risk was particularly obvious in patients with both depression and heart disease. While reasons for the link between depression and death risk is still unclear, it is suspected that stimulation of the body’s inflammatory system and clot formation process might be involved. Meanwhile, depression might alter cellular responses or the metabolism of blood fats. People with depression are frequently with negative lifestyle habits, including smoking, excessive alcohol consumption, lack of exercise, poor diet and lack of social support, which could interfere with treatment of heart disease. There is no evidence yet to show that treating depression would make adults less likely to have heart attack, but it is still worthwhile for doctors to pay more attention and conduct more vigorous medical monitoring on heart disease patients with depression. Recognizing depression as a risk factor of heart disease, American Heart Association (AHA) recommend that all cardiac patients be screened for depression using simple screening questions and an easy-to-administer survey known s the Patient Health Questionnaires (PHQ-2).
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