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How Depression Impacts People With Heart Disease

About one out of every five people with heart disease suffers from depression. And those with both conditions are more likely to likely to be hospitalized, use emergency rooms and spend more on healthcare, compared with cardiovascular patients without depression, according to preliminary research presented at the American Heart Association’s annual meeting held earlier this month.

Two studies that examined different aspects of depression and cardiovascular disease were led by Victor Okunrintemi, M.D., M.P.H., a research fellow at Baptist Health South Florida [1], and collaborator Javier Valero-Elizondo, M.D., M.P.H.

“While we don’t know which comes first–depression or cardiovascular disease—the consensus is that depression is a risk marker for cardiovascular disease, meaning if you have cardiovascular disease, there is a higher likelihood that you could also have depression, when compared with the risk in the general population,” says Dr. Okunrintemi.

In one study, Drs. Okunrintemi, Valero-Elizondo and colleagues evaluated the patient experience, healthcare expenditure and resource use of a large group of adults diagnosed with heart disease. They were divided into two groups: those who had been diagnosed with depression and those who had not been diagnosed with depression. The patients who had not been diagnosed with depression were then divided into high- and low-risk groups for depression.

The results revealed that those at high risk for depression spent more on overall and out-of-pocket healthcare expenses yearly, when compared with patients in the low-risk group.

“Another significant finding was that non-depressed cardiovascular disease patients at a high risk for depression had more health issues, increased use of the emergency room and a poorer perception of their health status and quality of life when compared with those who actually had depression,” Dr. Okunrintemi said. “That could be because people at high risk for depression simply haven’t been diagnosed and treated for depression yet.”

Specifically, those at high risk for depression were:

The second study compared the health resource use and expenditures of heart attack patients with and without depression. Dr. Okunrintemi and colleagues found that heart attack patients diagnosed with depression were 54 percent more likely to be hospitalized and 43 percent more likely to have emergency room visits, compared to those not diagnosed with depression.

“Depression and heart attack often coexist, which has been associated with worse health experiences for these patients,” he said. “We recommend more aggressive depression screening at follow-up visits for heart attack patients.”

In a separate study also featured at the American Heart Association’s meeting in Virginia, researchers studied more than 1,600 stroke patients after they left the hospital. At two times, three and six months after their strokes, the researchers found those diagnosed with depression before having a stroke were 56 percent more likely than those without depression to report “functional declines and a greater negative stroke-related impact on health and life.”