Even Mild Depression, Anxiety Hurts the Heart: Study

TUESDAY, July 31 (HealthDay News) — Even mild depression or
anxiety may raise your risk of dying from cardiovascular disease and other
causes, according to British researchers.

And the greater the level of psychological distress, the higher the
odds of death from heart disease, the researchers say.

“The fact that an increased risk of mortality was evident, even at low
levels of psychological distress, should prompt research into whether
treatment of these very common, minor symptoms can reduce this increased
risk of death,” said lead researcher Tom Russ, a clinical research fellow
at the Alzheimer Scotland Dementia Research Center of the University of
Edinburgh.

For the study, published online July 31 in BMJ, Russ and
colleagues analyzed 10 studies of men and women enrolled in the Health
Survey for England from 1994 to 2004. Data on more than 68,000 adults aged
35 and older was included overall.

Each study looked for connections between chronic psychological
distress and the risk of dying from heart disease and other causes,
including cancer.

Pooling data in this way is called a meta-analysis. In such a study,
researchers look for common patterns across several studies.

Over eight years’ follow-up, the researchers found even very mild
depression or anxiety — subclinical levels — raised the risk of
all-cause death, including cardiovascular disease, by 20 percent. Looking
specifically at death from heart disease, mild psychological distress
raised this risk 29 percent, the study found.

For the highest level of depression or anxiety, the risk of all-cause
death rose 94 percent, the researchers found.

Risk of death from cancer was increased 9 percent in cases of very
severe depression or anxiety, the investigators found. Lower levels of
psychological distress were not associated with increased risk of cancer
death.

An individual’s actual risk of death remains small, however, and people
shouldn’t assume they are doomed to an early death if they suffer from a
psychological disorder.

Dr. Glyn Lewis, a professor of psychiatric epidemiology at the
University of Bristol in England and author of an accompanying journal
editorial, said evidence linking stress to heart disease continues to
mount.

“If we can reduce the psychological impact, then this should reduce the
biological response,” he said. But how to accomplish that remains a
puzzle.

A type of psychological treatment called cognitive behavioral therapy
is designed to help people change the way they respond to potentially
stressful events, Lewis said. Cognitive behavioral therapy teaches
patients to change their thinking about situations and to react less
emotionally.

“This might help people with [clinical] depression, but there is no
evidence that this might help the much larger numbers of people who have
low-level symptoms that are below the diagnostic threshold for
depression,” he said.

While antidepressants might improve depression, previous studies have
linked their use to greater risk of heart disease, according to background
research in the study. About 7.5 percent of United Kingdom residents have
depression and anxiety disorders, Lewis said.

Changing this stress-disease dynamic might also involve keeping common
risk factors for cardiovascular disease in check, another expert said.

Dr. Gregg Fonarow, a professor of cardiovascular medicine at the
University of California, Los Angeles, said many studies have demonstrated
an association between depression and anxiety and cardiovascular events,
cardiovascular deaths and all-cause mortality.

But so far, no evidence has shown that treating depression or anxiety
reduces the risk of heart disease, Fonarow said.

Many different mechanisms may connect psychological distress to
cardiovascular disease, including increased sympathetic nervous system
activity, stress hormones such as cortisol, chronic inflammation,
unhealthy lifestyle factors and inattention to early symptoms, he
said.

“For people with depression or anxiety, focusing on proven
cardiovascular risk factor interventions, including maintaining healthy
blood pressure, body weight, cholesterol levels, engaging in regular
exercise and not smoking, may represent the best course of action to lower
their cardiovascular risk,” he advised.

More information

For more information on cardiovascular disease, visit the American Heart Association.

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