and Medicine for Seniors
Intense stress and depression almost
doubles death risk for heart patients
Short-term risk of death or heart
attack increased 48% for older heart patient in the high stress-high
14, 2015 - Few seniors are not aware that stress and depression are a
bad mix, yet, they very often link together – you are stressed or
depressed, which tends to cause the one you don’t already have to raise
its ugly head. The startling news is, however, that older people coping
with these two afflictions plus a heart problem are likely to see a
really big increase in their risk of a heart attack or death.
The research in Circulation:
Cardiovascular Quality and Outcomes, an American Heart Association
journal, examined the effect of high
stress levels and high
depression 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
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.
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.
Coping with stress and depression
after a heart attack can be hard, but you’re not alone – join the AHA
Support Network to
connect with others going through similar journeys.