Chronic depression after heart attack tied to increased risk of death

(Reuters Health) – Heart attack survivors with chronic mood disorders may be more likely to die prematurely than their counterparts who don’t suffer these problems, a recent study suggests.

Patients with anxiety or depression have previously been shown to have longer hospital stays and a worse prognosis after a heart attack, researchers note in the European Journal of Preventive Cardiology. But earlier research hasn’t given doctors a clear sense of whether patients with specific types of emotional distress might put patients at greater risk for serious complications or premature death.

For the current study, researchers assessed almost 58,000 patients for emotional distress two months after a heart attack, and again at 12 months after the event. Overall, 21% of the patients reported persistent psychological problems in both assessments.

Researchers followed a majority of patients for at least 4 years. Compared to those who didn’t report any emotional distress at all, people who felt depressed or anxious at both assessments were 46% more likely to die of cardiovascular causes during the follow-up period and 54% more likely to die from other causes.

“Temporary mood swings, if they are not too frequent or dramatic, are a normal part of life,” said senior study author Erik Olsson of Uppsala University in Sweden.

“Feeling a little depressed after a heart attack might even be a good thing if it makes you withdraw a bit and get some rest,” Olsson added. “Emotional states help us regulate our behaviors.”

About 15% of the patients in the study experienced some symptoms of emotional distress two months after the heart attack that they no longer reported after one year. Their odds of dying during the study period were no different from people who didn’t have anxiety or depression at either assessment.

It’s possible that people who reported depression and anxiety at both assessments had a harder time following doctors’ orders for an ideal recovery, Olsson said by email.

“Chronic emotional distress makes it harder to adopt the lifestyle changes that improve prognosis after a heart attack,” Olsson said. “These include quitting smoking, being physically active, eating healthily, reducing stress and taking prescribed medications.”

About 11% of the patients initially reported no symptoms of emotional distress but did feel some degree of depression or anxiety after one year.

These people didn’t appear at increased risk for dying of cardiovascular causes during the study period compared with patients reporting no emotional distress, but did have a 46% greater risk of dying from other causes.

These people may have had distress that wasn’t directly related to their heart attack, Olsson said. Instead, they might have experienced depression or anxiety due to other risk factors for mood disorders like poverty, limited education or lack of a spouse or job.

The study wasn’t a controlled experiment designed to prove whether or how mood disorders might directly hasten death after a heart attack.

It’s also possible that some people in the study had undiagnosed depression or anxiety prior to the heart attack that influenced their survival odds, the study authors note.

Researchers also looked at depression and anxiety combined, making it impossible to identify any differences in how each of these conditions might independently impact survival after a heart attack.

It’s also unclear whether treating depression or anxiety could impact outcomes, said Dr. Robert Carney of Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis, Missouri, who wrote an accompanying editorial.

“We do not know for certain whether treating depression or anxiety improves survival, but there is some evidence that it probably does,” Carney said by email. “At the very least, being free of depression and anxiety improves quality of life.”

SOURCE: and European Journal of Preventive Cardiology, online June 3, 2019.


more recommended stories

  • Dementia caregiving takes toll on sleep

    (Reuters Health) – Family caregivers for.

  • South Africa to roll out sweeping health reform in stages

    PRETORIA (Reuters) – A proposed move.

  • FDA classifies Edwards Lifesciences Sapien delivery system recall as severest

    (Reuters) – The U.S. Food and.

  • Plastic particles in drinking water present ‘low’ risk: WHO

    GENEVA (Reuters) – Microplastics contained in.

  • AstraZeneca’s Imfinzi misses main goal of advanced lung cancer study

    FILE PHOTO: A sign is seen.

  • AstraZeneca diabetes drug shows promise in heart failure

    (Reuters) – AstraZeneca (AZN.L) made strides.

  • Study prompts call for lower fluoride consumption by pregnant women

    (Reuters Health) – Adding fluoride to.

  • CDC investigates lung illnesses linked to e-cigarette use

    FILE PHOTO: A man vapes outside.

  • E.coli in water forces Tokyo to cancel swimming at Paratriathlon World Cup

    TOKYO (Reuters) – High levels of.

  • E.coli risk forces Tokyo to cancel swim events at Paratriathlon World Cup

    TOKYO (Reuters) – High levels of.

  • First two Ebola cases confirmed in Congo’s South Kivu – officials

    FILE PHOTO: Children look at a.

  • Surgical training programs not supportive of new parents

    (Reuters Health) – Surgical residents say.

  • Liver disease related to obesity and diabetes rising in U.S.

    (Reuters Health) – The only liver.

  • Ebola ‘no longer incurable’ as Congo trial finds drugs boost survival

    LONDON (Reuters) – Scientists are a.

  • Scientists hail promise of first effective Ebola treatments in Congo trial

    LONDON (Reuters) – Scientists are a.

  • China cuts 2019/20 corn use forecast by 2 million tonnes due to African swine fever

    Corn kernels are seen at a.

  • WHO says no new Ebola cases in Goma, vaccinates over 1,300

    FILE PHOTO: A young woman reacts.

  • Dengue death toll rises in Malaysia, number of cases close to double

    KUALA LUMPUR (Reuters) – Malaysia saw.

  • Amgen wins U.S. patent battle on arthritis drug Enbrel, thwarting Novartis

    (Reuters) – A U.S. judge on.

  • AstraZeneca’s Tagrisso helps lung cancer patients live longer: study

    (Reuters) – AstraZeneca Plc said on.

  • Study shows Apple devices in combo with apps could identify dementia

    FILE PHOTO: The new Apple iPhone.

  • Moving during early pregnancy may increase preterm birth risk

    (Reuters Health) – Moving to a.

  • Drug assistance programs offer little charity to uninsured

    (Reuters Health) – Many patients who.

  • In extreme heat, electric fans inadvisable unless it’s humid

    In extreme heat, electric fans may.

  • Trump administration considers September unveiling of healthcare plan: WSJ

    FILE PHOTO: U.S. President Donald Trump.

  • Bulgaria to compensate owners who cull pigs to help stamp out swine fever

    FILE PHOTO: A pig rests at.

  • Yellow lens glasses don’t improve drivers’ night vision

    (Reuters Health) – – Touted to.

  • U.S. FDA approves Daiichi Sankyo’s treatment for rare joint tumor

    (Reuters) – The U.S. Food and.

  • For some surgeries, hospital rankings not tied to better outcomes

    (Reuters Health) – When it comes.

  • Congo says Rwanda has closed border near Goma

    Congolese customs agents gather at the.

  • Pluristem gets positive results from radiation treatment trials

    TEL AVIV (Reuters) – Israel’s Pluristem Therapeutics.

  • Congress seeks briefing on potential threat to U.S. heparin supply

    WASHINGTON (Reuters) – Leaders of the.