Depression is a Heart Attack Risk Factor
Heart Disease and Depression are Linked, Exercise Reduces Risk of Both
May 28, 2009
Health experts have found a definite link between depression and cardiovascular disease. The American Heart Association is working to alert doctors and patients.
The statistics are alarming:
- Physically healthy people who are depressed have twice the risk of sudden cardiac death than those who are not depressed.
- Depression more than doubles a healthy person’s chances of having a heart attack or stroke.
- People with heart disease are more likely to become depressed than those who do not have heart disease.
- People with heart disease who become depressed are at the greatest risk of further cardiac problems.
The reason people with depression are more at risk for cardiovascular disease seems to be both behavioral and physiological.
Behavioral Reasons Why Depression is a Heart Attack Risk Factor
- Regular exercise and a healthy diet are known to improve cardiovascular health. People who are depressed find it more difficult to exercise and eat healthy foods.
- Social isolation is also a risk factor in heart disease, and people who are depressed tend to isolate themselves.
- Depression may squelch a person’s desire to take needed heart medications.
Physiological Links Between Depression and Heart Disease
Actual biological links have been observed between heart disease and depression.
- Depression is known to coincide with certain negative changes in two hormone systems that influence cardiovascular health: the hypothalamic-pituitary-adrenal axis and the rennin-angiotensin-aldosterone system.
- In people with depression, blood platelets tend to form clots more easily.
- Artherosclerosis and the rupture of cholesterol filled plaque may be more likely to occur in those who are depressed due to chemical changes in the body.
- Heart rate and rhythm may also be affected by depression.
How to Treat Depression in Those With Heart Disease
There is some evidence that treating depression is good for the cardiovascular system.
Standard treatments for depression seem to help those with depression and heart disease, with some qualifications. The standard treatments are:
- Antidepressant medication;
- Psychotherapy, and;
- Exercise.
Which Antidepressants Are Prescribed for People with Heart Disease?
There are certain antidepressant medications that tend to work well for patients with heart problems.
- Tricyclic antidepressants such as imipramine (Tofranil) and nortriptyline (Pamelor) can affect heart rhythms so these are generally not prescribed for people who have heart disease.
- Selective Serotonin Reuptake Inhibitors (SSRI’s) are usually prescribed and are considered safe for people with heart disease. However, there is no hard evidence that these drugs actually improve cardiovascular health.
- The American Heart Association recommends either sertraline (Zoloft) or citalopram (Celexa) as a first choice for those with heart disease and depression because these are considered the antidepressant drugs that are proven safe and effective for this group of people.
Psychotherapy for People With Depression and Heart Disease
In addition to standard types of therapy for depression that can be highly effective, psychotherapy can also help the individual with heart disease deal with feelings of fear about their health and feelings of loss with regard to their health.
Does Exercise Cure Depression and Prevent Heart Disease?
More and more evidence exists that people with mild or moderate depression can improve their mood through exercise. Exercise is also recommended as an adjunct to treatment for people with severe depression.
Exercise is good for the heart, other organs, and the body. It is also believed to cause new nerve cell growth in the hippocampus, one part of the brain that regulates mood. New evidence indicates that people can actually improve their brains through things like exercise.
How Much Exercise is Needed?
To improve the brain with exercise, people must exercise 35 minutes a day five times a week, or 60 minutes a day three times per week. The exercise should be of moderate intensity, such as walking at a pace that would amount to one mile in fifteen or twenty minutes. Those who exercise less do not seem to reap any benefits in their mood.
Evidence suggests that depression can increase the risk of heart disease and heart disease can increase the risk of depression. Breaking into this cycle of disease with exercise, healthy diet, social interaction, psychotherapy and/or medication should lead to a happier and healthier life.
Source:
- Two-Way Street Between Depression and Heart Disease, published in Harvard Medical School’s Harvard Mental Health Letter, Volume 25 Number 12, June 2009.
Anyone experiencing troubling physical or emotional symptoms should consult a medical doctor and/or mental health professional. This article is for general information only and is not intended to be personal medical or mental health advice.
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