Heart Disease and Depression – Recipe for Stroke

A new study by researchers at the Radboud University Nijmegen Medical Centre has found that heart patients who are also depressed face an increased risk of stroke. The researchers report their findings in May issue of the Archives of General Psychiatry.

There have been several studies that have linked depression and stroke. However, none of these studies have taken into account the presence of pre-existent cardiovascular disease and its effect on the chances of stroke. Additionally these studies were also limited in their measures of depression or stroke.

The team led by Dr. Lonneke Wouts set out to check just this – whether there is a link between cardiovascular disease, depression and an increased risk of stroke. The nine year study covered 2965 Dutch citizens, all aged 55 and above. The researchers used the Diagnostic Interview Schedule from the National Institute of Mental Health and the Depression Scale from the Centre for Epidemiological Studies to measure depression in the study participants.

None of the participants had suffered a stroke prior to the start of the study and a first stroke, fatal or non-fatal was the end point of the study for that particular participant. Over the course of the study, the researchers found that the incidence of stroke in patients with heart disease was more than double that of patients without heart disease.

Compared to patients without heart disease, those with the disease also had a direct association between the severity and chronic nature of their depressive symptoms and the development of stroke. Incidences of stroke were also higher for patients who had heart disease at the start of the study, older age, poor performance on a standard mental exam, greater functional limitation, diabetes, and high blood pressure.

“The evidence is emerging that depression and depressive symptoms in those with cardiac disease predict a worse cardiovascular prognosis, but thus far evidence does not support that current depression treatments lead to a better cardiovascular prognosis in this group,” study leader Dr. Wouts said.

“Nevertheless, antidepressants do have an effect on the depressive symptoms in this population in most studies,” Dr. Wouts added. “Therefore – from a mental health perspective – I would recommend treatment of depressive symptoms if indicated.”

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