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Posted by bio_man   May 16, 2023   1037 views

For quite some time it's been known in the medical community that a link exists between depression and heart disease. For example, large epidemiological surveys typically find that 1.5 to 3 percent of the population is depressed at any given time. Among patients with heart disease, however, the rate of depression is closer to 18 percent. Similarly, about 1 in 6 people in the general population has an episode of major depression during their lifetimes, compared to about 50 percent of people with heart disease. Finally, a Canadian study revealed that of 222 patients who had suffered heart attacks, those who were depressed were four times as likely to die within the next 6 months.

Amassing this evidence is one thing, but explaining it is quite another. One possibility is that heart disease is the result of biochemical changes that take place in depressed people, such as the secretion of stress hormones. An alternative explanation is that people who are depressed lack the cognitive, motivational, or emotional wherewithal to look after their health or take medications, leaving them more vulnerable to heart diseases such as arrhythmias or heart attacks.

A large-scale study by William Eaton at the Johns Hopkins School of Hygiene and Public Health suggests that the causal arrow points from depression to heart disease, but with a few stops along the way. Eaton and his colleagues studied 1,551 people in the Baltimore area who were free from heart disease in 1981. Those who were depressed were four times as likely to have a heart attack in the next 14 years, compared to those who were not depressed. In fact, depression was as strong a predictor of heart disease as was elevated levels of blood cholesterol. The physiological changes that take place in depressed people seem to be the culprits. For example, depressed people's hearts beat faster, their heart rate does not adjust well to changes in activities, and they tend to have elevated blood pressure — these factors in combination produce stress on the heart. Moreover, many depressed people are in a state of hyperarousal due to the secretion of cortisol: They sleep less, eat less, and although they feel mopey and lethargic, their fight-or-flight system is set on high. Cortisol also prompts the accumulation of abdominal fat, which in turn elevates the risk of heart disease. In sum, the well-known biochemical changes that take place in depression can increase a person's vulnerability to heart disease.

Heart disease depression Medicine
Posted in Research
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