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'Perfect storm' of stress, depression may raise risk of death, heart attack for heart patients

Date:
March 10, 2015
Source:
American Heart Association
Summary:
High stress and deep depression among heart patients may up the risk of death or heart attack by 48 percent. The findings validate the concept of a 'psychosocial perfect storm' for heart patients. Researchers say behavioral interventions may be needed to help heart patients manage both stress and depression.
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High levels of stress and depression up the risk of death or heart attack significantly in heart patients.
Credit: © Mi.Ti. / Fotolia

The combination of stress and heavy depression can significantly increase heart patient's risk of death or heart attack, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

The study examined the effect of high stress levels and high depressive symptoms among nearly 5,000 heart patients. Researchers concluded that risk is amplified when both conditions are present, thus validating the concept of a "psychosocial perfect storm."

"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 Carmela Alcántara, Ph.D., lead author of the study and associate research scientist at Columbia University Medical Center for Behavioral Cardiovascular Health in New York.

Study participants included 4,487 coronary heart disease patients, 45 years and older, enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.

During in-home examinations and self-administered questionnaires from 2003-07, participants were asked how often during the past week they felt depressed, lonely or sad, or had crying spells. To determine stress levels, participants were asked how often during the past month they felt they were unable to control important things in their lives, felt overwhelmed, felt confidence in their ability to handle personal problems and felt things were going their way.

About 6 percent reported both high stress and high depression.

During an average six-year follow-up, 1,337 deaths or heart attacks occurred. Short-term risk of death or heart attack increased 48 percent for those in the high stress-high depressive symptoms group compared with those in the low stress-low depressive symptoms group.

The elevated risk was most strongly associated with death rather than heart attack; additional result suggest the deaths may have been cardiovascular-related, but more research is needed, researchers said. The risk was significant only during the first two-and-half years from the initial home visit, and wasn't significant for those experiencing either high stress or high depressive symptoms alone, but not both at the same time.

Study findings may challenge traditional research paradigms that only focus on depression and its impact on patients with heart disease, Alcántara said. Behavioral interventions also should be considered to help heart disease patients manage both stress and depression better.


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Materials provided by American Heart Association. Note: Content may be edited for style and length.


Journal Reference:

  1. C. Alcantara, P. Muntner, D. Edmondson, M. M. Safford, N. Redmond, L. D. Colantonio, K. W. Davidson. Perfect Storm: Concurrent Stress and Depressive Symptoms Increase Risk of Myocardial Infarction or Death. Circulation: Cardiovascular Quality and Outcomes, 2015; DOI: 10.1161/CIRCOUTCOMES.114.001180

Cite This Page:

American Heart Association. "'Perfect storm' of stress, depression may raise risk of death, heart attack for heart patients." ScienceDaily. ScienceDaily, 10 March 2015. <www.sciencedaily.com/releases/2015/03/150310174109.htm>.
American Heart Association. (2015, March 10). 'Perfect storm' of stress, depression may raise risk of death, heart attack for heart patients. ScienceDaily. Retrieved May 26, 2017 from www.sciencedaily.com/releases/2015/03/150310174109.htm
American Heart Association. "'Perfect storm' of stress, depression may raise risk of death, heart attack for heart patients." ScienceDaily. www.sciencedaily.com/releases/2015/03/150310174109.htm (accessed May 26, 2017).

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