A diagnosis of coronary artery disease that is coupled with depression could double the risk of mortality. This is according to a new study. And, although researchers don’t know what the exact mechanism is behind the correlation between depression and heart disease, more and more studies confirm it.
The most common and widespread form of heart disease is coronary artery disease or CAD. However, it’s apparent that the effect of psychological distress or depression doubles the risk of premature death in patients of CAD. Furthermore, a large-scale study to investigate this link was launched by a team of researchers in Salt Lake City, UT.
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Intermountain Medical Center Heart Institute Study
The study, headed up by Heidi May, PhD took place at the Intermountain Medical Center Heart Institute in Salt Lake City. The team was directed toward investigating the association between those who were diagnosed with CAD and then afterward were diagnosed with depression. A group of 24,137 CAD patients were examined. (They had all been diagnosed by angiography.) In addition, the patients were examined with the International Classification of Diseases Codes to determine if they were also suffering from depression.
The Cox Hazard Regression models were also used to adjust the time periods between the diagnosis of CAD and the diagnosis of depression. There was a differentiation of time periods between patients.
About 15% of the test subjects were diagnosed with depression at the CAD follow-up examination. The majority of these patients were female and younger than the depression-free CAD patients. Furthermore, they were also more apt to have diabetes along with a previous diagnosis of depression. However, during follow-up, they were the group less likely to develop a myocardial infarction or heart attack.
Of those who were diagnosed with depression, 27% were diagnosed inside of a year of the CAD diagnosis. There were 24% who were diagnosed within 1 to 3 years after the CAD diagnosis. And about 15% between 3 to 5 years. Only about 37% were diagnosed 5 years following the CAD event.
The Strongest Predictor of Death
In spite of all the variables and adjustments, the team concluded that the strongest predictor of death was “Post CAD Depression”. Furthermore, when one is diagnosed with depression any time following a CAD diagnosis, the risk of premature death doubles. And, the prediction was equally strong for patients with no previous history of depression. In fact, the correlation remained despite the fact that depression happened immediately following the CAD diagnosis or many years later.
Dr. May said, “We’ve completed several depression-related studies and been looking at this connection for many years. The data just keeps building on itself, showing that if you have heart disease and depression and it’s not appropriately treated in a timely fashion, it’s not a good thing for your long-term well-being.”
As the lead of the study, Dr. May further remarks, “We know people with depression tend to be less compliant with medication on average and probably, in general, aren’t following healthier diets or exercise regimens.”
“They tend to do a poorer job of doing things that are prescribed than people without depression. That certainly doesn’t mean you’re depressed, so you’re going to be less compliant, but in general, they tend to follow those behaviors.”
She says that another explanation could involve the physiological changes that tend to happen as a result of depression. Depression is accompanied by a wide range of symptoms, as studies have shown. These indicate that this psychological disorder and bodily reactions are associated biologically.
In conclusion, Dr. May firmly suggests that practitioners continue testing for depression after the patient is diagnosed with CAD or heart disease. Even years later, depression should be tested for and treated whenever treatment is called for.
“I hope the takeaway is this: it doesn’t matter how long it’s been since the patient was diagnosed with coronary artery disease. Continued screening for depression needs to occur … After 1 year, it doesn’t mean they’re out of the woods.”
These findings have been published in the European Heart Journal: Quality of Care & Clinical Outcomes.