Depression and cardiac function in patients with stable coronary heart disease: findings from the Heart and Soul Study
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Published on: December 2, 2015
Heather Lett1, Sadia Ali, Mary Whooley
1VA Palo Alto Health Care System, Palo Alto, California, USA.
Insights
Depression does not appear linked to worse cardiac disease severity in stable coronary heart disease (CHD) patients. This finding suggests cardiac severity is unlikely to explain the higher risk of cardiovascular events in depressed individuals.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Research
Background:
- Depression is a known risk factor for adverse cardiovascular events in patients with coronary heart disease (CHD).
- A potential confounding factor is whether depressed patients have worse baseline cardiac disease severity.
- This study investigates the relationship between depression and cardiac disease severity in stable CHD patients.
Purpose of the Study:
- To determine if depression is associated with increased cardiac disease severity in patients with stable coronary heart disease (CHD).
- To address the criticism that observed associations between depression and cardiovascular outcomes may be confounded by baseline cardiac status.
Main Methods:
- A cross-sectional study of 1020 outpatients with stable CHD.
- Major depression was assessed using the Computerized National Institute of Mental Health Diagnostic Interview Schedule.
- Cardiac disease severity was measured by systolic and diastolic dysfunction, exercise-induced ischemia, and cardiac wall motion abnormalities, analyzed using univariate and multivariate models.
Main Results:
- 22% of participants (224 out of 1020) reported major depression.
- After adjusting for age, major depression was not significantly associated with any measure of cardiac disease severity.
- Multivariate analyses also showed no significant relationship between major depression and cardiac disease severity.
Conclusions:
- The study found minimal evidence linking depression to worse cardiac disease severity in stable CHD patients.
- This suggests that poorer baseline cardiac health in depressed individuals is unlikely to be the reason for their increased risk of cardiovascular events.
Objective:
To determine whether depression is associated with worse cardiac disease severity in patients with stable coronary heart disease (CHD). There is considerable evidence that depression is a risk factor for adverse cardiovascular events in patients with CHD. However, a frequent criticism of this literature is that the association between depression and adverse cardiovascular outcomes may be confounded by worse baseline cardiac disease severity in depressed patients.
Method:
In a sample of 1020 outpatients with stable CHD, we examined the association between major depression (assessed using the Computerized National Institute of Mental Health Diagnostic Interview Schedule) with measures of cardiac disease severity, including systolic dysfunction, diastolic dysfunction, exercise-induced ischemia, and cardiac wall motion abnormalities. Cross-sectional univariate and multivariate models controlling for demographic and clinical variables were computed.
Results:
Of the 1020 participants, 224 (22%) had current (past month) major depression. After adjustment for age, major depression was not associated with systolic dysfunction, diastolic dysfunction, inducible ischemia, or cardiac wall motion abnormalities. Similarly, multivariate models revealed no significant relationship between major depression and cardiac disease severity.
Conclusions:
Overall, we found little evidence that depression is associated with worse cardiac disease severity. This suggests that greater baseline cardiac disease severity is unlikely to be responsible for the increased risk of CHD events in depressed patients.
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