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Clinical Depression and
Increased Risk of Death Following a Heart Attack
 It has been known for some
time that heart attack patients who also experience clinical depression are at
a much higher risk for subsequent heart attacks in the months following the
initial attack. Now, researchers from Washington University in St. Louis,
Missouri have found that the risk probably continues for many years after.
Robert M. Carney, Ph.D.,
professor of psychiatry at Washington University and the lead author of the
new study stated that "There's a two to fourfold increase in a person's risk
of dying following a heart attack if they also happen to be depressed." He
went on to say that "Previously we thought the impact of depression was
strongest for the first three to six months following a heart attack and then
gradually dropped off within a couple of years. Instead, we found that the
effect lasts for at least five years."
Dr. Carney, along with
colleagues from Yale University, Duke University Medical Center, Harvard
University and the National Heart, Lung and Blood Institute (NIH) and the Mayo
Clinic, studied more than 750 heart attack patients for five years. Patients
in the study had participated in the NIH funded project Enhancing Recovery in
Coronary Heart Disease with a little less than half being diagnosed as having
depression. Of this group, 106 patients died in the five years following a
heart attack, with 62 of these having been diagnosed with depression and 44
had not. In isolating the effects of the depression, researchers also
considered such risk factors as smoking, hypertension, age, diabetes and
gender.
Some of these factors were
found to lower mortality risks such as being younger and female. Diabetes and
smoking had a tendency to raise the risk of death. Carney and his team used
statistical methods to isolate the mortality risk associated with the various
factors. They were able to remove the influence of the various other factors
from the risk factors associated with depression, to isolate the statistical
impact of depression alone, in order to judge an individual's risk of dying.
Dr. Carney stated that "We found that after adjusting for those risk factors,
depression continues to play a statistically significant role."
One explanation that was
given as a possibility is that depression seems to have a lingering influence
on mortality due to its high level of recurrence. Because it frequently comes
and goes, it seems to have a continuing influence on the risk of death for
many years subsequent to the initial heart attack. Dr. Carney concluded that
"People typically are depressed for a while, then they'll either get better
with treatment or it may subside on its own." He went on to say "But
depression can always recur, and we think that because it is a recurring
problem, whatever depression is doing to mortality risk after a heart attack,
it continues doing for quite a long time."
Page
two will be coming up shortly
Information adapted from Clinical Depression
Raises Risk of Death Fro Heart Attack Patients Years After Attack Science
Daily, March 4, 2008
Information and webpage by
Paul Susic
MA Licensed Psychologist Ph.D.
Candidate
(Health and Geriatric Psychologist
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