Depression Treatment

Healthcare professionals have long known that depression is a risk factor for cardiovascular problems such as heart attack and stroke. Now a new study published in the January issue of Psychosomatic Medicine has shown that treating depression in its early stages can help reduce the risk of these problems.

Jesse Stewart, an associate professor of psychology at Indiana University-Purdue University Indianapolis and the author of the study, believes that this research could make way for new approaches for preventing cardiovascular disease.

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Cutting Risk Almost in Half

The study evaluated 235 patients ages 60 years and older who were diagnosed with depression. The patients were randomly assigned to receive either antidepressants and psychotherapy or standard care determined by their physician. In each group, some patients had existing cardiovascular disease and some did not. Patients who had no evidence of heart disease at the beginning of the study were given antidepressants and therapy for their depression. Over the course of eight years, this group of patients almost halved their risk of a heart attack or stroke, compared with the standard care group.

Over the study period, 119 patients reported having cardiovascular problems such as a heart attack or stroke. Of the 168 with no heart disease at the start of the study, those who received therapy and medication were 48 percent less likely to have a stroke or heart attack than those in the standard care group. Study participants who received both medicine and therapy, but who had heart disease when they enrolled in the study, did not show a lower risk of heart attack or stroke than those receiving standard care.

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Cautioning that the results are preliminary and do not prove cause and effect, but only an association, Stewart emphasized that depression is linked with physiological changes, such as an increase in inflammation, a known risk factor for heart disease.

It is also noteworthy that people who suffer from depression may also be more likely to engage in behaviors that can increase the risk for heart attack and stroke. These can include smoking, not engaging in physical exercise, eating an unhealthy diet, and being less compliant with medication regimens.

Symptoms of Depression Linked to Coronary Artery Disease

A separate study recently published in the European Journal of Preventive Cardiology showed that symptoms of depression may be causally linked to the risk of coronary artery disease (CAD).

Researchers, including Dr. Eric Brunner of the Research Department of Epidemiology and Public Health at University College London (UCL), analyzed data on 10,308 civil servants in the U.K. who were a part of the Whitehall II study. The subjects were followed for 20 years. Every two to three years, health assessments were made and any major stroke or CAD events were recorded. Participants were also measured on six occasions for their “exposure to depression.”

Participants who showed depressive symptoms in the first one or two assessments showed no increased risk of CAD. However, study participants who had symptoms of depression in the third or fourth assessments showed a 100 percent increase in CAD risk.

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