Heart disease worsens among depressed patients

People with heart disease who are depressed often have a higher risk of a future heart attack or stroke because the depression keeps them from adhering to advice on exercise and eating healthy foods, according to a study published today in the Journal of the American Medical Assn.

The relationship between heart disease and depression is well-known and is of such concern that last month the American Heart Assn. recommended that doctors screen all heart patients for depression. A  story on the recommendation and reaction to it was published by the Los Angeles Times.

Previous studies have shown that the two disorders often co-exist, but there has been little evidence to explain why. The new research, by scientists at the VA Medical Center, San Francisco, looked at 1,017 people with heart disease and followed them for almost five years. The participants completed questionnaires to measure symptoms of depression, and researchers kept track of any cardiovascular events, such as stroke, heart failure, heart attack, transient ischemic attack and death.

The study found that the heart disease patients with depression had a 31% greater risk of cardiovascular events. But when the researchers adjusted for the patients' health behaviors, such as physical inactivity, there was no longer a significant association between heart disease and depression. Physical inactivity was associated with a 44% greater rate of cardiovascular events.

Exercise, it appears, may be useful for treating the depression and limiting the risk of future cardiovascular problems. The researchers wrote: "The increased risk of cardiovascular events associated with depression could potentially be preventable with behavior modification, especially exercise."

-- Shari Roan