Depression and Heart Disease

Depression often occurs with heart disease.  For help with depression related to coronary issues, please seek help.

From Depressive Symptoms, Cardiovascular Disease Severity, and Functional Status in Older Adults With Coronary Heart Disease: The Heart and Soul Study by Nancy L. Sin, PhD, Kristine Yaffe, MD, Mary A. Whooley, MD, J Am Geriatr Soc. 2015;63(1):8-15.

Introduction

Individuals with cardiovascular disease (CVD) are living longer, but the burden of disease remains high, particularly in older adults.[1] Conventional CVD therapies are based on randomized trials that have excluded individuals with multiple comorbid conditions and frailty that are common with advanced age.[2] These trials typically focus on reducing mortality or recurrent cardiovascular events, but people are concerned not only with prolonging event-free survival, but also with maximizing their functional status and quality of life.[3] As longevity improves in older adults with CVD, the promotion of long-term functional independence has become a critical goal of clinical disease management.

Despite the importance of functional status to older adults with CHD, the extent to which depressive symptoms rather than CVD severity determine long-term functional status is unknown. The current study compared the contributions of depressive symptoms with those of CVD severity (left ventricular ejection fraction (LVEF), exercise capacity, and angina frequency) for predicting subsequent functional decline in 960 older adults with stable CHD.

Conclusion

In older adults with coronary heart disease, depressive symptoms and lower exercise capacity predicted functional decline over 5 years. In contrast, other traditional measures of CVD severity (LVEF and angina pectoris) were not independently predictive of subsequent functional status. These findings suggest that efforts to ameliorate depressive symptoms may be as important as treating CVD severity to enhance functional status.