Heart Attack Support Group
Heart attack is a serious, sudden heart condition usually characterized by varying degrees of chest pain or discomfort, weakness, sweating, nausea, vomiting, and arrhythmias, sometimes causing loss of consciousness. It occurs when the blood supply to a part of the heart is interrupted, causing death and scarring of the local heart tissue.
Lack of Exercise Explains Depression-Heart Link
By TARA PARKER-POPE
For years cardiologists and mental health experts have known that depression raises risk for heart attack by 50 percent or more.
But what hasnt been clear is why depressed people have more heart problems. Does depression cause some biological change that increases risk? Does the inflammatory process that leads to heart disease also trigger depression?
The answer may be far simpler. A new study suggests that people who are depressed are simply less likely to exercise, a finding that explains their dramatically higher risk for heart problems.
Researchers, led by doctors from the Veterans Affairs Medical Center in San Francisco, recruited 1,017 participants with heart disease to track their health and lifestyle habits. As they expected, those patients who had symptoms of depression fared worse. About 10 percent of depressed heart patients had additional heart problems, during the study, compared with 6.7 percent of the other patients. After controlling for other illnesses and the severity of heart disease, the finding translates to a 31 percent higher risk of heart problems among the depressed people, according to the study published this week in the Journal of the American Medical Association.
But once the researchers factored in the effect of exercise, the difference in risk among depressed people disappeared. In the same study, patients who didnt exercise, whether or not they were depressed, had a 44 percent higher risk of heart problems, after controlling for a variety of factors including medication adherence, smoking and other illnesses.
The findings are important because some earlier studies have suggested a link between antidepressant use and lower heart risk. The explanation may be that patients who take antidepressants start to feel better and take care of themselves, adopting healthy behaviors including exercise. In a study of nearly 2,500 heart-attack patients, published in the Journal of the American Medical Association in June 2003, behavioral therapy to treat depression didnt change survival rates compared with patients who received regular care. But among about 20 percent of patients in the study who ended up on antidepressants, the risk of dying or suffering a second nonfatal heart attack was 42 percent lower. Another study, called Sadheart (which stands for Sertraline Antidepressant Heart Attack Randomized Trial) showed the death rate from heart-related problems was 20 percent lower among patients taking the drug, although the data werent statistically significant.
The research suggests that doctors treating patients for depression should also talk to them about their lifestyle habits, and encourage them to exercise. The findings, say the researchers, suggest that the heart problems associated with depression could potentially be preventable.
The evidence that health behaviors fully explain the link between depression and heart disease in this study is convincing, says Dr. Mary A. Whooley, professor of medicine, epidemiology and biostatistics at the University of California, San Francisco. However, she notes the study is limited to older men with stable coronary disease, and as a result, more study is needed of women and other patients with heart disease.
It remains an open question whether the study findings will change the way doctors counsel their patients. The clinical practice question is a challenging one, says Dr. Whooley. Its easy for us to tell patients to exercise, take their medicines, and refrain from smoking, but actually changing health behaviors is very difficult.
By TARA PARKER-POPE
For years cardiologists and mental health experts have known that depression raises risk for heart attack by 50 percent or more.
But what hasnt been clear is why depressed people have more heart problems. Does depression cause some biological change that increases risk? Does the inflammatory process that leads to heart disease also trigger depression?
The answer may be far simpler. A new study suggests that people who are depressed are simply less likely to exercise, a finding that explains their dramatically higher risk for heart problems.
Researchers, led by doctors from the Veterans Affairs Medical Center in San Francisco, recruited 1,017 participants with heart disease to track their health and lifestyle habits. As they expected, those patients who had symptoms of depression fared worse. About 10 percent of depressed heart patients had additional heart problems, during the study, compared with 6.7 percent of the other patients. After controlling for other illnesses and the severity of heart disease, the finding translates to a 31 percent higher risk of heart problems among the depressed people, according to the study published this week in the Journal of the American Medical Association.
But once the researchers factored in the effect of exercise, the difference in risk among depressed people disappeared. In the same study, patients who didnt exercise, whether or not they were depressed, had a 44 percent higher risk of heart problems, after controlling for a variety of factors including medication adherence, smoking and other illnesses.
The findings are important because some earlier studies have suggested a link between antidepressant use and lower heart risk. The explanation may be that patients who take antidepressants start to feel better and take care of themselves, adopting healthy behaviors including exercise. In a study of nearly 2,500 heart-attack patients, published in the Journal of the American Medical Association in June 2003, behavioral therapy to treat depression didnt change survival rates compared with patients who received regular care. But among about 20 percent of patients in the study who ended up on antidepressants, the risk of dying or suffering a second nonfatal heart attack was 42 percent lower. Another study, called Sadheart (which stands for Sertraline Antidepressant Heart Attack Randomized Trial) showed the death rate from heart-related problems was 20 percent lower among patients taking the drug, although the data werent statistically significant.
The research suggests that doctors treating patients for depression should also talk to them about their lifestyle habits, and encourage them to exercise. The findings, say the researchers, suggest that the heart problems associated with depression could potentially be preventable.
The evidence that health behaviors fully explain the link between depression and heart disease in this study is convincing, says Dr. Mary A. Whooley, professor of medicine, epidemiology and biostatistics at the University of California, San Francisco. However, she notes the study is limited to older men with stable coronary disease, and as a result, more study is needed of women and other patients with heart disease.
It remains an open question whether the study findings will change the way doctors counsel their patients. The clinical practice question is a challenging one, says Dr. Whooley. Its easy for us to tell patients to exercise, take their medicines, and refrain from smoking, but actually changing health behaviors is very difficult.
Not only does depression lead to reduced likelihood of exercising, but exercising appears to lead to reduced depression, improved mood. I know I feel best emotionally when I exercise regularly, though not always easy to find the time and energy to do!
Now, I'm gonna get myself off the couch, and do some exercise (while watching tv!)!
Thanks, again, Louie.
Well I was also diagnosed with congestive heart failure in june. Suffered for months till they figured it out. From feb/mar on. Dr thought it could have been a virus that attacked my heart, now he thinks it could also have been from periods of high blood pressure, but there's no way to tell for sure. I was 45 years old, alone, and terrified. Dr says to me the day it was diagnosed that typically I would put you right in the hospital and treat you now. What I'm going to do instead is call in your prescriptions, you go and pick them up, and treat yourself at home!! I hadn't experienced none of the typical side affects that others do in my condition, because of the condition of my mind and body. Yes my heart was now functioning at 30% on my left side when it should be between 50-60% but I was living life as usual, not knowing. I was throwing around 200+ lb men in aikido, I was playing golf, cutting the grass, working and working around the house, not knowing my heart was weak. What I was experiencing was that I had water in my lungs that wasn't being cleared because my heart was weak. It was making me cough, especially at night so I lost sleep, many nights with no sleep, for months. Up coughing all night. I got to the point where I was sleeping sitting up on the recliner. I did start to experience loss of breath a few days before I was diagnosed though.
So I got home, alone and terrified. What a scary thing to hear about yourself. I took my meds as instructed. I went to bed that night thinking, I'm alone, what if I don't wake up! The dr told me to get back to the hospital if I had to, if something comes up but I that should be fine. So as the night passed I was up peeing like crazy. Peeing out the water in my lungs, the meds were working. Halfway through the night I was actually able to sleep lying down. For the first time in 4-5 months!!. And when I woke I felt like myself again!
The dr instructed me to take it easy, no golf, no aikido, no work around the house, etc. And I did, for a month when I had my next visit, it was a good one. My heart started to improve slightly. So I could back to light stuff, play golf again but no aikido. I continued with the meds, played golf and did what I could but I sat on the bench for 5-6 months in aikido rather than hit the mat to train. And continued to take the meds. During this period I had a stress test on my heart. As they had me on the treadmill trying to tax me to inject me for the test I kept going and going. They were having trouble tiring me out. The first indication I gave them that I might be starting to tire they injected me and took a pic of my heart. Good results, getting better, no blockages. I live a clean life. Never smoked, never did drugs of any kind, don't drink alcohol that much, eat as healthy as I can. My weight is fine, cholesterol was fine, I'm athletic and active.
After 6 months I had another echo of my heart and it showed I was back to normal, that my heart had recovered :-) So I'm back to my normal active life, back on the mat training in aikido. They call me superman there. I didn't miss one day of work, or spend one day in the hospital. With congestive heart failure. I recovered because I exercise my mind, body, and spirit often :-) And though I get down and depressed it keeps me going. I've been through a lot in life and I'm a survivor but without exercising who knows where I'd be now.
I hope my positive story lifts your spirit.
TL
God Bless,
Louie