Depression and heart disease are linked

(ORDO NEWS) — For generations, people have been interested in the connection between mind and body. For example, do people really die of a broken heart? Does a healthy mind mean a healthy body?

Scientists have long been studying the links between mental and physical health. One such association is between depression and heart disease.

Studies have shown that depression is more common in people with heart disease compared to the general population.

In addition, physically healthy people, if followed for many years, are more likely to develop cardiovascular disease than people without depression.

We also know that in people with acute heart disease (for example, those who have had a heart attack), depression is associated with an increased risk of new heart attacks and death, not only from heart disease, but from any other cause.

However, fewer studies have been devoted to examining whether there is a reverse trend – that is, whether risk factors for cardiovascular disease are associated with a higher likelihood of developing depression. A new study published in the journal PLOS ONE attempts to find out.

What the researchers did

Sandra Martín-Pelaez of the University of Granada in Spain and her colleagues focused on people with metabolic syndrome to study the association between cardiovascular disease risk factors and depression in people aged 55 to 75.

Metabolic syndrome is a group of diseases that occur together, including high blood pressure, high blood sugar, excess fat around the waist, and high cholesterol, and which increase the risk of heart disease, stroke, and type 2 diabetes.

Some researchers suggest that metabolic syndrome may play a role in the development of depression.

Participants in this study were selected from a larger trial looking at the effects of the Mediterranean diet on people who are overweight or obese and have metabolic syndrome.

The current randomized trial consists of one group on a calorie-restricted Mediterranean diet and physical activity program and another group on an unrestricted Mediterranean diet without a physical activity program.

It is difficult to unambiguously interpret the results of this study. The data was analyzed in several different ways, and the results were mixed.

For example, the authors analyzed data on various factors in the metabolic syndrome and found that diabetes and certain cholesterol levels resulted in lower rates of depression at follow-up.

However, other studies show that women with heart disease have higher levels of depression than men with heart disease. It is also well known that in the general population women suffer from depression more often than men.

Therefore, the finding that there may be an association between heart disease risk and depression in women is consistent with these trends.

Why are depression and heart disease linked?

While we cannot conclude from this study that heart disease risk is associated with an increased risk of depression, it adds to the already strong evidence that heart disease is associated with depression.

This relationship can be explained by a number of factors, behavioral and biological. Some of the biological factors common to depression and heart disease risk include:

– increased inflammation
– endothelial dysfunction (narrowing of blood vessels in the heart)
– changes in the activity of the autonomic nervous system (the autonomic nervous system controls muscles, including the heart)
– platelet dysfunction (when platelets stick together more often and form blood clots).

In addition, we know that healthy lifestyle factors, such as being physically active, not smoking, and eating healthy, protect against both heart disease and depression.

The reverse is also true unhealthy lifestyle factors are associated with an increased risk of heart disease and depression.

Unfortunately, it is more difficult for people with depression to change such habits, such as quitting smoking. Therefore, perhaps the most interesting result of this study is that depression levels decreased in the group that was encouraged and supported to adopt a healthier lifestyle, including a more restrictive diet and increased physical activity.

While there is strong evidence that exercise is a very effective treatment for depression in people with cardiovascular disease, the role of diet as a treatment for depression is less clear.

This study provides a promising impetus for further exploration of diet and lifestyle as potential treatments for depression in people with and at risk of developing cardiovascular disease.

Frank Doyle, Senior Lecturer in the Department of Health Psychology, RCSI University of Medicine and Health Sciences.

More than 6,500 participants were included in the original analysis of the PLOS ONE study, and more than 4,500 participants were followed up two years later.

The researchers used the well-known Framingham Risk Score, which was developed by following healthy people over a long period of time to determine the main risk factors for developing cardiovascular disease. They categorized people into groups at low, medium, and high risk of having a heart attack or dying from heart disease within ten years.

Participants were asked about symptoms of depression using questionnaires initially (when they started diet and physical activity programs) and then two years later.

Surprisingly, no significant association was found between cardiovascular risk and depression either initially or later. Thus, in general, participants with a higher risk of cardiovascular disease were not prone to depression.

When the authors analyzed the data by gender, they found that at baseline, women with higher cardiovascular risk were more likely to have depressive symptoms. But this was not the case for males, and neither for males nor females during follow-up.

On average, after two years, all participants had reduced depression scores. Depression scores decreased more in those who had low cardiovascular risk and in intervention group participants (participants who followed a restricted diet and physical activity program).


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