Anxiety and Depression Predict Events
in Heart Patients
—Anthony J. Brown, MD
New research indicates that anxiety and depression are risk factors
for major heart-related events among patients with stable coronary
artery disease.
"We found that both major depression and generalized anxiety
disorder were more common in cardiac patients than in the general community.
More importantly, both predicted about a doubling in risk for major
cardiac events over two years," study chief Dr. Nancy Frasure-Smith,
from the University of Montreal, told Reuters Health.
She added that her study differed from previous research in that it
focused on patients with stable heart disease -- not on those who were
hospitalized for a cardiac event such as heart attack.
As reported in the Archives of General Psychiatry this month, Frasure-Smith
along with Dr. Francois Lesperance, also from the University of Montreal,
examined the prognostic significance of depression and anxiety in 804
patients with stable heart disease who were followed for 2 years.
Overall, 27 percent of patients showed signs of depression on a standard
test and 41 percent showed signs of anxiety. Major depressive disorder
was diagnosed in roughly 7 percent of patients while about 5 percent
had generalized anxiety disorder.
Major depressive disorder, generalized anxiety disorder, as well as
elevated scores on the depression and anxiety tests all increased the
risk of a major coronary event. Of these, major depressive disorder
was the strongest factor, increasing the risk by 2.85-fold. No additive
effect was seen; patients with both major depressive disorder and generalized
anxiety disorder had roughly the same risk of suffering a major coronary
event as patients with just one of the disorders.
"Now that we know that both generalized anxiety disorder and
major depression are markers of increased cardiac risk, it is imperative
that these patients receive the best evidence-based treatment for both
their cardiac and psychiatric conditions," Frasure-Smith emphasized.
"Extra efforts are justified in helping them change their cardiac
risk factors, assure treatment compliance, and improve their emotional
and social functioning," she added. |
