According to a news study published in Circulation: Cardiovascular Quality and Outcomes, depression and stress combined increase the risk of death and heart attack in patients with heart disease.
In this study, 4,487 patients with heart disease were assessed for the effects of high levels of stress and depressive symptomatology, with the researchers concluding that when both conditions are present the overall risk of death and heart attack is enhanced. Based on these results, the researchers stated that there is validity in the concept of a “psychosocial perfect storm.”
Patients aged over 45 years were recruited for the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. From 2003 to 2007, all participants underwent in-home examinations and filled self-report measures assessing depressive symptoms. For stress level assessment, patients were asked to assess theirs levels of impaired cope with normal stress routines. Results revealed that nearly 6% of study participants had both high levels of stress and high levels of depression. At 6 years follow-up the researchers found that a total of 1,337 deaths or heart attacks occurred.
Those patients who suffered from both conditions were found to have a 48% increased short-term risk of death or heart attack, in comparison to those who reported low levels in both conditions. The increased risk was found to be significantly related with death rather than heart attack, however more research is necessary to understand the stability of these findings, said Dr. Carmela Alcántara, study’s lead author and associate research scientist at Columbia University Medical Center for Behavioral Cardiovascular Health in New York.
Statistical analyses revealed this increased risk was only meaningful during the first two-and-half years from the initial home visit, and was non-significant for those participants who only presented high stress levels or high depressive symptoms.
The researchers indicate that these results confront the conventional research theories which usually only assess depression effects on patients suffering from heart disease. The results also emphasize the need for behavioural interventions in patients with heart disease to appropriately manage their stress and depression symptoms.
“The increase in risk accompanying high stress and high depressive symptoms was robust and consistent across demographics, medical history, medication use and health risk behaviors,” said Dr. Alcántara, in a recent news release.