Nav: Home

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

March 10, 2015

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.
-end-
Co-authors are Paul Muntner, Ph.D.; Donald Edmondson, Ph.D., M.P.H.; Monica M. Safford, M.D.; Nicole Redmond, M.D., Ph.D., M.P.H.; Lisandro D. Colantonio, M.D., M.Sc.; and Karina W. Davidson, Ph.D. Author disclosures are on the manuscript.

The National Institute of Neurological Disorders and Stroke at the National Institutes of Health funded the REGARDS study.

Additional Resources:
  • Coping with stress and depression after a heart attack can be hard, but you're not alone - join the AHA Patient Support Network to connect with others going through similar journeys.
  • Stress and Heart Health
  • Four ways to deal with stress
  • Depression and Heart-Disease
  • Follow AHA/ASA news on Twitter @HeartNews
  • Follow CircCVQO on Twitter: Circulation: CVQO@CircOutcomes

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.

American Heart Association

Related Depression Articles:

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.
Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.
Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.
Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.
Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.
CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.
Post-natal depression in dads linked to depression in their teenage daughters
Fathers as well as mothers can experience post-natal depression -- and it is linked to emotional problems for their teenage daughters, new research has found.
Being overweight likely to cause depression, even without health complications
A largescale genomic analysis has found the strongest evidence yet that being overweight causes depression, even in the absence of other health problems.
Don't let depression keep you from exercising
Exercise may be just as crucial to a depression patient's good health as finding an effective antidepressant.
Having an abortion does not lead to depression
Having an abortion does not increase a woman's risk for depression, according to a new University of Maryland School of Public Health-led study of nearly 400,000 women.
More Depression News and Depression Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.