Cardiovascular Diseases (CVD)
The American Heart Association (AHA) reports that cardiovascular disease (CVD) ranks as the number one killer of Americans, accounting for a 36 percent share of annual deaths. In addition, 79.4 million people in the United States are living with some form of CVD.
CVD and Depression
You already know that about one in five people have an episode of major depression in their lifetimes, but that number climbs to about one in two for people with CVD. That means that 3 to 5 percent of the general population is depressed at any one time. With heart patients that figure is 18 percent. That's a significant statistic.
One of the positive consequences of being the number one killer is that there's no shortage of studies looking into the problem, both here in the United States, as well as abroad. Several of these studies considered the role of depression in CVD.
Fact
Cardiovascular diseases include arteriosclerosis, coronary artery disease, heart valve disease, arrhythmia, heart failure, hypertension, orthostatic hypotension, shock, endocarditis, diseases of the aorta and its branches, disorders of the peripheral vascular system, and congenital heart disease.
Studying the Old Ticker
Think depression is just an annoyance? Recent studies have investigated the role depression can play in heart attacks and found that depression turns out to be a reliable indicator of risk, equal to previous heart attack. Here's what some studies uncovered:
A Montreal Heart Institute study found that depressed patients who'd had heart attacks were four times more likely to die within six months than those who were not depressed.
A Washington University study found that depressed people with newly diagnosed heart disease were twice as likely to have a heart attack or require bypass surgery.
A Johns Hopkins study found that those who were depressed were four times more likely to have a heart attack within fourteen years than those who were not.
An Ohio State University study found that depressed men were 70 percent more likely to develop heart disease. The number was only 12 percent for women but increased to 78 percent for cases of severe depression.
A Queen's Medical Center (UK) study found that depressed men were three times more likely to develop ischemia (heart damage from blockages of blood).
Alert
If you have cardiovascular disease, be sure to talk with your cardiologist about what you can expect to experience, regarding symptoms. If you find yourself becoming overly tired, even though your medication has been carefully monitored, you may be experiencing symptoms of depression, and you should tell your doctor about this.
In spite of the research findings, heart patients are not routinely tested or treated for depression. The focus has primarily been on the primary condition of CVD. In light of the research, however, this may change.
Depression in CVD
If you've been used to living life on your own terms, a diagnosis of CVD may turn everything upside down. That body that you've been taking for granted suddenly seems to have become a betrayer, and you're brought up short by the realization that being in control is an illusion.
So you take a long, hard look at that physical shell of yours and you may not like what you see. You may also feel some guilt for having treated it with a cavalier attitude in the past. Life as you've known it is about to change. The upshot? You're experiencing the symptoms of depression.
Overcoming Depression in CVD
Tell your cardiologist how you're feeling. Not just the shortness of breath, the palpitations, sweats, dizziness, or fatigue — although these might be related to depression — but everything about how you're feeling. Go back to review the list of depression's symptoms. If you see yourself there, it's time to discuss this with your physician. It might seem simplistic, but depression is often overlooked.
Essential
Beta blockers act upon the autonomic nervous system. They block substances such as adrenaline (epinephrine) to relieve stress on the heart, lessen the force with which the heart muscle contracts, and reduce blood vessel contraction in the heart, brain, and throughout the body.
It's important to feel better while you're getting better! Antidepressants can help you deal with the downside of your CVD, and psychotherapy can help you make positive changes in your life. If you've survived a heart attack, you've got a second chance to get it right. Sometimes, just sharing what you're going through is enough to take the edge off. Take all the opportunities you can find that will help.
Medication and Side Effects
The American Heart Association (AHA) reports that some medications used to treat CVD may have depression as a side effect. These medications include the following:
Beta blockers: Acebutolol (Sectral), atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), pindolol (Visken), propranolol (Inderal), or timolol (Blocadren)
Peripheral adrenergic inhibitors
If you are taking any of these medications and are experiencing depressive symptoms, work with your cardiologist to get to the heart of the problem!
