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Sunday, 12 August, 2001, 23:17 GMT 00:17 UK
Risk to depressed heart patients
Patients with depression and heart disease had a worse prognosis
Patients with depression and heart disease had a worse prognosis
Patients with heart failure are twice as likely to die within a year if they are also severely depressed.

They are also twice as likely to be readmitted to hospital during that time.

The researchers, from the Duke University Medical Center in Durham, North Carolina, said their finding indicated all patients with serious heart failure should be assessed for major depression.

Dr Wei Jiang, who led the research, said: "Heart failure is a deadly disease, and now we know that those patients who are suffering from major depression are at a much greater risk of death."


Heart failure is a deadly disease, and now we know that those patients who are suffering from major depression are at a much greater risk of death

Dr Wei Jiang,
Duke University Medical Center
UK campaign groups for heart health and depression said the US study reinforced the need for further research into the links between physical and mental health.

Around 63,000 new cases of heart failure are reported in the UK each year.

'Check for depression'

The researchers looked at 357 patients who were admitted with heart failure to Duke University over 15 months.

Thirty five per cent had symptoms of depression, with 14% diagnosed as having major depression.

Patients who were depressed had a death rate of 26%after a year, compared to just under 14% of non-depressed patients.

Eighty per cent of patients with major depression were readmitted within a year, compared to 52% of those who were not depressed.

Dr Jiang said if more heart specialists checked for depression, and treated those who had it, patients' prognosis may improve.

She said: "Obviously, the next step is to see whether treating these patients' depression will have a beneficial outcome on their heart failure.

But it is not known how major depression may influence how the heart works.

Dr Jiang said: "People with major depression tend to have poor social support networks or perceive their social support insufficient and may not be as compliant with their medications.

"Also some studies have shown an association with depression and higher activity of platelets, which can cause clots in arteries."

Counselling

The researchers were keen to stress the patients they studied had depression that could be clinically diagnosed, rather than simply being sad about their condition.

One difficulty is that anti-depressants could interact with medications people are on for their heart condition.

So other therapies such as counselling or psychotherapy could be the answer.

Craig Haslop, spokesman for the British Heart Foundation said: "Research has already shown that patients who have a heart attack are three times more likely to have a second attack if they are depressed.

"It is not clear why depression may lead to a second heart attack - but it could be assumed that depression may also inhibit recovery from other types of coronary heart disease such as heart failure.

"More research is needed into depression and its links with heart failure. Factors such as a poor social network, and dealing with a life threatening disease, need to be considered in future research to better understand why depression may contribute to mortality from conditions such as heart failure."

A spokeswoman for the mental health charity MIND told BBC News Online a link between depression and the period after serious illness was well-documented.

She said people with mental health problems may be more likely to be unemployed or on low incomes, factors which have been linked to heart disease.

Smoking and drinking may also be coping strategies people with mental health problems employ.

The research was published in the journal Archives of Internal Medicine.

See also:

10 Aug 01 | Health
GPs 'not spotting' heart failure
06 Mar 01 | Health
Heart failure damage reversed
18 Oct 00 | Health
Test for heart failure
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