One recent study of people with heart failure found that depression was associated with increased mortalit y but that use of antidepressants was not.
“We suspect that their use is a marker for people with worse depression,” explained Dr. William Whang, an assistant professor of clinical medicine at Columbia University Medical Center in New York City. “The elevated risk seems more specific for antidepressant use, but that use may well be a marker of more severe symptoms.”
The link between depression and heart trouble is physical not psychological, Whang added. “We found that women who had worse depressive symptoms had higher rates of risk factors such as hypertension, diabetes and smoking,” he said.
Whang and his team evaluated data collected from over 63,000 American women in the Nurses Health Study. And while the research team did find a link between depression and heart risk, the incidence of sudden cardiac death was associated more strongly with the use of antidepressant drugs than with symptoms of depression.
Earlier studies linked depression and a higher mortality rate for people who already had heart disease, Whang said. “But this was a group of women without heart disease, and that makes it different,” he noted.
Doctors treating women with depression should take note. “The biggest clinical implication is that management of coronary heart disease risk factors may be especially important for those with depressive symptoms,” he said. “Taking care of those risk factors can modify the risk for coronary disease.”