Depression May Up Heart Attack Risk

Cardiac patients who are depressed are less likely to exercise , which increases their risk of a cardiac event
such as a
heart attack or
heart failure , a new study suggests.

So heart patients who experience
depression may be able to lower their cardiac risk simply by getting more
physical activity.

It's long been recognized that patients who suffer from depression are more likely to have heart attacks
or other cardiac events. But the reason for the association has been unclear.
According to the new study, published in The Journal of the American Medical
Association, the higher risk may be due to behavioral factors, especially
physical activity levels.

Researchers looked at 1,017 heart disease patients. All were outpatients at
clinics in the San Francisco area. They were recruited between 2000 and 2002,
and followed until early 2008.

Participants completed a questionnaire to gauge whether or not they had
depressive symptoms. Out of the group, 199 had depressive symptoms. The
depressed patients were more likely to smoke, were less likely to take their medications as
prescribed, and were less physically active.

Among the participants with depression, 10% had a cardiac event during the
follow-up period. Among the non-depressed participants, 6.7% had a cardiac
event. Cardiac events included heart failure, heart attack,
stroke ,
transient ischemic attack (sometimes referred to as a
"mini-stroke"), or death.

Even when the researchers made mathematical adjustments that accounted for
other health issues and the severity of heart disease at the outset of the
study, the group with depression was still 31% more likely to have a cardiac
event than the group without depression. However, when lifestyle factors were
also accounted for, there was largely no difference between the likelihood of a
cardiac event for the depressed group and for the non-depressed group. In the
final statistical model, the researchers found that physical inactivity alone
was associated with a 44% greater rate of cardiovascular events.

"These findings raise the hypothesis that the increased risk of
cardiovascular events associated with depression could potentially be
preventable with behavior modification, especially exercise," the
researchers write. "Exercise training can improve both depressive symptoms
and markers for cardiovascular risk."

The researchers point out that their study could not discern whether
depression led to inactivity or if inactivity led to depression. Regardless,
the incorporation of exercise into a comprehensive depression
treatment plan may be beneficial to many patients who suffer from both
depression and heart disease.

By Caroline Wilbert
Reviewed by Elizabeth Klodas
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