Thursday, March 12, 2009

Depression, Heart Disease, Nurse's Study, Risk Factor

Two recent reports from studies on depression remind us once again of the mind-body connection. It has been known for quite some time that depression is common in those patients who have suffered a heart attack or stroke and that those who have depression tend to have a worse survival outcome. The American Heart Association recommends that everyone with heart disease be regularly screened for depression. It also has been shown that those with diabetes have an increased risk of depression but also that depression is an independent risk factor for the development of diabetes. Now the same link has been shown with depression and heart disease. Depression is an independent risk factor for the development of heart disease similar to high cholesterol and hypertension.

The American Journal of Cardiology reported findings from The Nurse's Study which involved 63,000 women who were followed from 1992-2004. None of the women(mostly white) had heart disease but 8% had depression. Those with depression were found to have twice the risk of dying from sudden cardiac death than those without and to a lesser degree other forms of heart disease. Sudden cardiac death usually results from an abnormal heart rhythm. An additional interesting finding was that the use of antidepressants was linked to the increase in sudden cardiac death although the newer antidepressant medications have not been associated with heart rhythm abnormalities. It is thought that the use of antidepressants is more common in those with severe depression and that might account for the findings but further research needs to be done.

A recent paper presented at the American Psychosomatic Society showed a similar depression- heart disease link. The Washington University of St. Louis along with the Veteran's Administration studied twins from 1992-2005. Twin studies are often used to help determine the degree of genetic influence in a disease. They found that in those with a genetic risk of both heart disease and depression those who had depression at the onset of the study developed heart disease while those at genetic risk who did not have depression did not develop heart disease.

Both these studies show once again the potential devastating effects of depression and support the idea that there needs to be adequate insurance benefits for evaluation and treatment of depression which will reduce overall disease burden as well as decrease total health care costs.

Thought for the day

The mind and body are inseparable.

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