Depression and Heart Disease
"Those who are depressed are four times more likely to have a heart attack."
Heart disease may be the leading cause of death, but much of the work is accomplished by a silent killer lurking in the shadows. If heart disease is the loud boisterous attention-grabber, depression is the slow insidious operator working on the inside, wearing way at the psyche, sapping the victim of the will to look after himself, and very subtly disrupting the body's biological processes, eventually setting up its more publicity-prone partner for the knockout blow.
The figures speak for themselves:
About one in five people have an episode of major depression in their lifetimes. That number climbs to about one in two amongst people with heart disease. One point five to three percent of the population is depressed at any given time. With heart patients it's 18 percent.
According to a Montreal Heart Institute study involving 222 subjects, depressed patients with heart attacks are four times more likely to die within six months as their non-depressed counterparts. A Washington University study found that depressed people with newly-diagnosed heart disease are twice as likely to have a heart attack or require bypass surgery. A recent Johns Hopkins study involving 1,551 people concluded that those who are depressed are four times more likely to have a heart attack within fourteen years.
An Ohio State University study of 8,000 subjects found that depressed men were 70 percent more likely to develop heart disease. The number was significantly lower for women at 12 percent, but shot up to 78 percent for cases of severe depression. A Queen's Medical Center (UK) study of 5,623 patients discovered that depressed men are three times more likely to develop ischemia (heart damage from blockages of blood) and are at higher risk of subsequent episodes.
In fact, depression turns out to be a reliable indicator of risk, equal to previous heart attack, according to an editorial in the Medical Journal of Australia, as well as high cholesterol, impaired left ventricular function after heart attack, and, according to a University of Pittsburgh study, greater than high blood sugar in diabetics.
Unbelievably, in light of this, the possibility of depression is rarely addressed by the physicians who treat heart disease. In one study, almost none of the patients were accurately diagnosed or treated with antidepressants over a seven-month period - this despite the fact that heart patients respond well to SSRIs and are safe for them to take.
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