Depression doubles risk of death after heart attack, angina

March 8, 2017, American College of Cardiology
Credit: George Hodan/Public Domain

Depression is the strongest predictor of death in the first decade following a diagnosis of coronary heart disease, according to a study scheduled for presentation at the American College of Cardiology's 66th Annual Scientific Session. The study found people with coronary heart disease who are diagnosed with depression are about twice as likely to die compared with those who are not diagnosed with depression.

"This study shows that it doesn't matter if depression emerges in the short term or a few years down the road—it's a risk factor that continually needs to be assessed," said Heidi May, PhD, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute in Salt Lake City and the study's lead author. "I think the take-home message is that patients with need to be continuously screened for depression, and if found to be depressed, they need to receive adequate treatment and continued follow-up."

The study focused on patients diagnosed with a heart attack, stable angina or unstable angina, all of which are caused by a reduced flow of oxygen-rich blood to the heart, typically as a result of plaque buildup in the heart's arteries. These conditions fall under the umbrella term coronary heart disease, which is the most common form of heart disease and kills about 370,000 people in the United States annually.

Researchers have long understood heart disease and depression to have a two-way relationship, with depression increasing the likelihood of heart disease and vice versa. Whereas previous studies have investigated depression occurring within a few months of a coronary heart disease diagnosis, the new study is the first to shed light on the effects of depression over the long term.

The researchers analyzed health records from almost 25,000 Intermountain Health System patients tracked for an average of nearly 10 years following a diagnosis of coronary . About 15 percent of patients received a follow-up diagnosis of depression, a substantially larger proportion than the estimated rate of 7.5 to 10 percent in the general population.

Out of 3,646 people with a follow-up diagnosis of depression, half died during the study period, compared to 38 percent of the 20,491 people who did not have a depression diagnosis. This means people with depression were twice as likely to die compared to those without depression.

After adjusting for age, gender, risk factors, other diseases, heart attack or chest pain, medications and follow-up complications, the results showed depression was the strongest predictor of death in this patient group. These results were consistent regardless of age, gender, the timing of depression onset, past history of depression or whether or not the patient had a .

Given the significant impact of depression on long-term survival, the researchers said clinicians should seek ways to better identify depression in patients with , either by using patient questionnaires designed to screen for depression or by actively watching for signs of depression during follow-up examinations.

"It can be devastating to be diagnosed with ," May said. "Clinicians need to pay attention to the things their patients are expressing, in terms of both physical symptoms as well as emotional and nonverbal factors."

Signs of depression include persistent feelings of sadness, hopelessness or worthlessness; anxiety, irritability or restlessness; losing interest in hobbies and activities; fatigue or moving slowly; difficulty sleeping or concentrating; aches or pains without a clear physical cause; changes in appetite or weight; and thoughts of death or suicide. Depression is linked with behaviors that can be detrimental to cardiovascular health, such as reduced physical activity, poor diet, increased smoking or alcohol use and reduced compliance with medical treatment.

The study did not evaluate the impact of treatment on the risk of death.

May will present the study, "The Association of Depression at Any Time to the Risk of Death Following Coronary Artery Disease Diagnosis: The Intermountain INSPIRE Registry," on Friday, March 17, 2017, at 9:30 a.m. ET at Poster Hall C at the American College of Cardiology's 66th Annual Scientific Session in Washington. The meeting runs March 17-19.

Explore further: Depression after heart disease diagnosis tied to heart attack, death

Related Stories

Depression after heart disease diagnosis tied to heart attack, death

March 23, 2016
New research shows patients with a history of chest discomfort due to coronary artery disease—a build up of plaque in the heart's arteries—who are subsequently diagnosed with depression are much more likely to suffer ...

Improving depression symptoms can reduce risk of major cardiovascular problems, study finds

April 3, 2016
Depression is a known risk factor for cardiovascular disease, but as a person's depression improves—or grows worse—their risk for heart disease has remained largely unknown.

Patients with acute coronary syndrome at increased risk of suicide

December 7, 2016
Patients with acute coronary syndrome, an umbrella term for conditions where the heart's blood supply is suddenly blocked, may be at an increased risk for suicide compared to otherwise healthy people, according to new research ...

Exercise reduces heart disease risk in depressed patients

January 11, 2016
Symptoms of mild to minimal depression were associated with early indicators of heart disease in a research letter published today in the Journal of the American College of Cardiology, but the study found regular exercise ...

New study links antidepressants with improved cardiovascular outcomes

March 5, 2015
A new study by researchers at the Intermountain Medical Center Heart Institute has found that screening for and treating depression could help to reduce the risk of heart disease in patients with moderate to severe depression.

Depressed patients have more frequent chest pain even in the absence of coronary artery disease

August 31, 2015
Depressed patients have more frequent chest pain even in the absence of coronary artery disease, according to results from the Emory Cardiovascular Biobank presented at ESC Congress today by Dr Salim Hayek, a cardiologist ...

Recommended for you

Study reveals a promising alternative to corticosteroids in acute renal failure treatment

September 21, 2018
A protein produced by the human body appears to be a promising new drug candidate to treat conditions that lead to acute renal failure. This is shown by a study conducted at São Paulo State University (UNESP) in São José ...

Can a common heart condition cause sudden death?

September 20, 2018
About one person out of 500 has a heart condition known as hypertrophic cardiomyopathy (HCM). This condition causes thickening of the heart muscle and results in defects in the heart's electrical system. Under conditions ...

New drugs could reduce risk of heart disease when added to statins

September 20, 2018
New drugs that lower levels of triglycerides (a type of fat) in blood could further reduce the risk of heart attack when added to statins. These new drugs, which are in various stages of development, could also reduce blood ...

Mediterranean-style diet may lower women's stroke risk

September 20, 2018
Following a Mediterranean-style diet may reduce stroke risk in women over 40 but not in men—according to new research led by the University of East Anglia.

Inflammation critical for preventing heart attacks and strokes, study reveals

September 19, 2018
Inflammation, long considered a dangerous contributor to atherosclerosis, actually plays an important role in preventing heart attacks and strokes, new research from the University of Virginia School of Medicine reveals.

People who walk just 35 minutes a day may have less severe strokes

September 19, 2018
People who participate in light to moderate physical activity, such as walking at least four hours a week or swimming two to three hours a week, may have less severe strokes than people who are physically inactive, according ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.