According to the National Institutes for Mental Health, research over the past two decades has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people. In addition, people with depression are at greater risk for developing heart disease.
A study presented by Emory cardiology researcher Emir Veledar, PhD, today at the American College of Cardiology's 54th Annual Scientific Sessions in Orlando underscores the complexity of the connection between depression and cardiovascular disease. "We found that depression was one of the most significant predictors of health status, independent of the extent of disease and other cardiac risk factors," says Dr. Veledar. The researchers studied cross-sectional baseline data from 1707 cardiac patients (1463 males and 243 females) who participated in the Courage Trial. Depression and perception of health status were assessed with standardized screening forms. Physical factors and other risk factors were also assessed including age, gender, whether or not the patient lived alone, race, number of diseased vessels, prior angioplasty and/or bypass surgery, ejection fraction, the presence of congestive heart failure, diabetes, diabetes, hypertension, renal disease, previous stroke, physical activity, and physical exam data.
"Although there were no gender differences in angina frequency, angina stability and disease perception , women had lower treatment satisfaction and viewed themselves as having greater physical limitation. This might be explained because they had higher depression levels," says Dr. Veledar.
He points out that depression was ranked very high among predictors on the Seattle Angina Questionnaire (SAQ) which was used to assess perceived health status -- the more depressed heart patients were, the more sick they felt, regardless of gender.
"So the real cause for having low health status scores on the SAQ was not gender but depression. People with depression but without severe heart disease feel worse than non-depressed people with depression with heart disease," Dr. Veledar states. "Depression is still not widely accepted as a risk factor for the health status of cardiac patients but we think clinicians are moving toward understanding the importance of treating depression in these patients."
In addition to Dr. Veledar, the research team included Jerome Abramson, PhD; Viola Vaccarino, MD, PhD; William Weintraub, MD; and Cheryl Lewis, RN, BSN, of Emory University; Pamela Hartigan, PhD, VA Connecticut Healthcare System; Koon Teo, MD, McMaster University Medical Center; John Spertus, MD, MPH, Mid America Heart Institute; William Boden, MD, Hartford Hospital; and Robert O'Rourke, MD, University of Texas.