South Asians are four times more likely to have coronary artery disease than any other ethnic group according to the South Asian Heart Center, and experiencing a cardiac event can be a life-changing event. It brings to life the reality of your mortality and how close you may have come to losing the control over your life.
For most cardiac patients, experiencing sadness, guilt, anger, frustration and anxiety is very common. However, for up to 30% of cardiac patients the feelings of sadness, hopelessness and guilt, among others do not ease up over a few weeks. A study published in the American Heart Journal identified that as many as 20% of patients with cardiovascular disease or coronary artery bypass surgery experienced major depression.
Here is a snapshot of the most commonly asked questions regarding the depression-heart disease link.
Does depression cause heart disease?
Researchers at Washington University have found that depression is a bigger risk factor for cardiovascular disease than diabetes, high cholesterol, smoking or obesity. People who are depressed tend to have a more unhealthy lifestyle: exercising infrequently, having an unhealthy diet that is higher in fat and cholesterol, smoking and not taking medications consistently. Not participating a heart-healthy lifestyle due to depression can trigger a recurring cardiac event, creating a vicious cycle that is difficult to break.
The direction of causality between heart disease and depression is still unknown; however, most researchers, psychologists and cardiologists are concluding that it does not really matter. Most important is understanding how depression affects heart patients and what can be done to improve the prognosis after a cardiac event.
How does depression affect the heart?
People who are depressed have bodies that are under tremendous amount of stress. Unmanaged stress due to untreated depression can lead to high blood pressure, damage to the arteries, weakened immune system and irregular heart beats.
In addition, people who are depressed show increased platelet reactivity and a significant increase in inflammation in the body. All of these are risk factors for developing cardiovascular disease and increases the risk of death to 17% six months after a heart attack as opposed to a 3% mortality rate after a heart attack in non-depressed patients.
How does depression affect recovering from a cardiac event?
After a heart attack or a cardiovascular surgery, depression intensifies pain. Research has also shown that patients with cardiovascular disease and depression are significantly more likely to be readmitted to a hospital, have a repeat cardiac event or die than cardiac patients who are not depressed.
Depression also worsens fatigue from the cardiac event, medications and surgery. The fatigue as well as other symptoms of depression negatively affect the patient’s ability to make crucial lifestyle changes to recover, such as exercising more, maintaining a healthier diet, attending cardiac rehabilitation programs or adhering to a new medication regimen.
Researchers from University of Wisconsin-Madison have found that a depressed person’s chance of dying are four times higher than a non-depressed person even if they have the same extent of heart damage.
Identifying the signs of depression and treating it early can be the best thing you can do for your chance of a full recovery from a cardiac event. With the rates of cardiovascular disease in the South Asian community so much higher than any other community, paying attention to your emotional health as part of your recovery plan can increase your odds of surviving heart disease and living a long life.
What do you think about the heart disease and depression connection?