Depressed heart patients at risk for stroke: study
By Will Boggs, MD
NEW YORK (Reuters Health) - Depression increases the risk of stroke in people with heart disease, results of a Dutch study indicate.
In a study lasting 9 years, the presence of depressive symptoms was associated with a greater than twofold higher incidence of stroke in elderly patients with heart disease, but such symptoms were not significantly associated with stroke in elderly patients without heart disease.
Similarly, the severity and chronic nature of depressive symptoms were significantly associated with the development of stroke among patients with heart disease, but not among patients without heart disease.
Heart disease at the start of the study, older age, poorer performance on a standard mental exam, greater functional limitation, diabetes, and high blood pressure were also associated with a higher incidence of stroke.
In comments to Reuters Health, study investigator Dr. Lonneke Wouts from Radboud University Nijmegen Medical Center said: "The evidence is emerging that depression and depressive symptoms in those with cardiac disease predict a worse cardiovascular prognosis, but thus far evidence does not support that current depression treatments lead to a better cardiovascular prognosis in this group."
"Nevertheless, antidepressants do have an effect on the depressive symptoms in this population in most studies," Wouts concluded. "Therefore -- from a mental health perspective -- I would recommend treatment of depressive symptoms if indicated."
SOURCE: Archives of General Psychiatry, May 2008.