Having depression and heart disease double death risk
A new study has examined the risk of premature death in patients having been diagnosed with both depression and coronary artery disease.
Dr. May and team examined a total of 24,137 patients with CAD, as diagnosed by an angiography. Using the International Classification of Diseases codes – a standard diagnostic tool – the researchers determined whether or not the patients had depression.
They then used Cox hazard regression models to adjust for the different periods of time that had elapsed between being diagnosed with CAD and being diagnosed with depression. These lengths of time differed from patient to patient.
Having adjusted for all of these factors, the researchers found that “post-CAD depression was the strongest predictor of death.”
In fact, being diagnosed with depression at any point after receiving a CAD diagnosis raised the risk of dying prematurely by twofold.
Even among patients who had no history of depression diagnosis, this correlation was just as strong.
Furthermore, the correlation persisted regardless of whether depression occurred right after being diagnosed with CAD or years later.
“We’ve completed several depression-related studies and been looking at this connection for many years,” says Dr. May. “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.”
Although this is an observational study that cannot explain causality, the lead author of the study ventures a hypothesis, saying, “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.”
Another possible explanation, the researcher says, may involve the physiological changes that tend to happen as a result of depression.
In fact, studies have pointed to a wide range of symptoms that sometimes accompany depression, indicating that this psychological disorder and its bodily symptoms are deeply connected on a biological level.
Finally, Dr. May urges clinicians to continue to test for depression and treat it where necessary, even years after the patient has been diagnosed with heart disease.
“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.”
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