Tuesday Sep 30, 2008 (foodconsumer.org) -- Doctors from
the American Heart Association released a new report Monday to urge patients
with heart disease to receive screening for depression because it claims that
depression can adversely affect their health and quality of life.
More than 80 million people in the US suffer some form of
heart disease, which is the number killer in the country.
Depression is common in patients with
cardiovascular disease, including acute myocardial infarction (heart attack).
In the report, researchers reviewed dozens of studies and
concluded that depression was three times more likely found in people who had
experienced a heart attack compared with the general population.
The depression risk seemed even higher among women who
have had heart attack.
One study published in the April 24, 2006 issue of
Archives of Internal Medicine showed women age 60 or younger were more likely
than other patients to be depressed during hospitalization for heart attack.
JAMA and Archives Journals published a press release on April
24, 2006 saying "Depressed heart attack patients are more likely to be
hospitalized and die of heart problems and tend to have worse health and higher
health care costs than heart attack patients who are not depressed."
For the study, Susmita Mallik, M.D., M.P.H., Emory
University School of Medicine, Atlanta and colleagues survey 2,498 patients
hospitalized with acute myocardial infarction between 2003 and June 2004 in the
United States for their depression.
They found women and younger patients were more likely to
suffer depression than men and older patients with younger women at highest
risk.
They found depression in 40 percent of women
age 60 or younger, 21 percent in women older than 60, 22 percent in men 60 or
younger and 15 percent in men older than 60.
With other factors considered, the risk of depression for women age 60
and younger was three times higher than that for men older than age 60 years.
The researchers did not know why younger women were most
likely to suffer depression after heart attack, but suggested hormones and
social pressures might be part of the reason.
The new report said depression rates among those who were
hospitalized for unstable angina, angioplasty, bypass surgery or vale surgery
were similar to those who had a heart attack.
Erika Froelicher, a professor at the UCSF School of
Nursing and Medicine said depression could also cause heart attacks because
people with depression might not exercise or eat well or they might smoke.
An early study suggested that depression could lead to an
increase in risk of heart failure.
The study of 32 people with heart failure showed 14
patients who felt the most depressed had nearly twice the levels of an
inflammation protein in their blood suggesting that depression may worsen heart
failure.
The study conducted by Amy Ferketich of public health at
Ohio State University and colleagues and published in a Sep 2005 issue of the
American Heart Journal found the level of a cytokine called tumor necrosis
factor alpha or TNF-alpha was found particularly higher in those who were highly
depressed patients.
In patients who had heart failure, this inflammation makes
it harder for the heart to pump blood. Heart failure by definition is a
condition in which the heart loses its ability to pump blood with normal
efficiency.
Normally, heart failure patients have high levels of this
protein, but it appears that depression makes levels of this cytokine even
higher, which is bad for patients, said Ferketich whose study confirmed the
claim.
Other researchers estimated that anywhere from 24 to 42
percent of heart failure patients also suffered from depression.
"Depression clearly raises the levels of one
cytokine, which plays a role in increasing inflammation," Ferketich said.
"What we don't know for sure is if depression causes the inflammation
which may lead to heart failure or if heart failure causes depression which
accelerates inflammation."
A study at Duke University found patients with major
depression were twice as likely to die or to be re-admitted to the hospital a
second time within 12 months.
"Patients with heart disease are prone to developing
depression," Ferketich said. "Physicians need to pay more attention
to this. But research still needs to be done to find out if treating patients
with anti-depressants would help to actually slow the progression of heart
disease."
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