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Why Cardiac Clients Become Depressed

Why Cardiac Clients Become DepressedThe increased risk of cardiovascular events for patients with coronary heart disease and symptoms of depression appears to be largely explained by a change in health behaviors, especially a lack of physical activity. Depression has long been recognized as a risk factor for the development of cardiovascular disease in healthy patients and for recurrent events in patients with established cardiovascular disease.

Despite the substantial body of evidence demonstrating a strong link between depression and cardiovascular disease, the explanation for this association remains unclear, according to background information in the article.

“Understanding how depression leads to cardiovascular events is necessary for developing interventions to decrease the excess cardiovascular morbidity [illness] and mortality [death] associated with depression,” the authors write.

Mary A. Whooley, M.D., of the VA Medical Center, San Francisco, and colleagues conducted a study to determine why depressive symptoms are associated with an increased risk of cardiovascular events.

The study included 1,017 outpatients with stable coronary heart disease who were followed for an average of 4.8 years.

Symptoms of depression were measured with a questionnaire, and various models were used to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events (heart failure, heart attack, stroke, transient ischemic attack [a temporary cessation or reduction of blood supply to part of the brain], or death) were explained by disease severity at the beginning of the study and potential biological or behavioral factors.

The researchers found that participants with depressive symptoms had a 50 percent greater risk of cardiovascular events: the age-adjusted annual rate of cardiovascular events was 10.0 percent among the 199 participants with depressive symptoms and 6.7 percent among the 818 participants without depressive symptoms.

Adjustment for physical activity was associated with a reduction in the strength of association between depressive symptoms and cardiovascular events.

When adjusted for other existing conditions and cardiac disease severity, depressive symptoms remained associated with a 31 percent higher rate of cardiovascular events. After further adjustment for certain health behaviors, including physical inactivity, there was no longer a significant association between depressive symptoms and cardiovascular events.

Physical inactivity was associated with a 44 percent greater rate of cardiovascular events, after adjusting for various factors.

The researchers note that patients with depressive symptoms are less likely to adhere to dietary, exercise, and medication recommendations, and poor health behaviors can lead to 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.

“Given the relatively modest effects of traditional therapies on depressive symptoms in patients with heart disease, there is increasing urgency to identify interventions that not only reduce depressive symptoms but also directly target the mechanisms by which depression leads to cardiovascular events.”

The new study is published in the November 26 issue of JAMA.

Source: JAMA and Archives Journals

Why Cardiac Clients Become Depressed

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Why Cardiac Clients Become Depressed. Psych Central. Retrieved on October 17, 2018, from https://psychcentral.com/news/2008/11/26/why-cardiac-clients-become-depressed/3415.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.