Baystate Doctor Discusses Link Between Depression, Heart Disease

SPRINGFIELD — How many times have you heard the major risk factors for heart disease?

High blood pressure. High blood cholesterol. Obesity. Stress. Diabetes. Family history. Lack of physical activity. But, did you know depression plays a role as well?

“The link between heart disease and depression hasn’t received the recognition it should. We’ve known about the connection for over 40 years, but it doesn’t come to the forefront like hypertension or high cholesterol, for example,” said Dr. Heba Wassif, a non-invasive cardiologist at Baystate Health.

February is American Heart Month. Cardiovascular disease is the leading cause of death in the U.S. One in every three deaths is from heart disease and stroke, equal to 2,200 deaths per day.

The Baystate cardiologist noted that depression and heart disease have received growing attention in research studies. Some of these studies have reported a threefold increase in cardiovascular disease among depressed patients, while others note that people with heart disease, who later become depressed, have an increased risk of dying after a heart attack.

“While people who are depressed are more likely to develop heart disease, the good news is that seeking help for your depression, which nobody should be ashamed about, can greatly improve both your mental and physical health,” she added.

Signs of depression include feeling irritable; having trouble concentrating or making decisions; feeling tired or having no energy; feeling hopeless or helpless; trouble sleeping, or sleeping too much; change in appetite resulting in weight gain or loss; loss of pleasure in activities you once enjoyed; feelings of worthlessness, self-hate, and guilt; and thoughts about death or suicide.

Wassif noted that the connection between depression and heart disease goes both ways. “Oftentimes, patients with no history of mental illness become depressed after suffering a heart attack or after developing heart failure, as well as after undergoing heart surgery such as bypass.”

These patients also have a greater mortality rate for reasons that are both biological and behavioral, she noted. “We know that stress hormones released into the bloodstreams of depressed individuals accelerate the buildup of plaque on artery walls. This results in ongoing inflammation and the possible dislodging of plaque into the bloodstream, which can trigger a heart attack.

“Also,” she went on, “people who are depressed often do not adequately take care of themselves. They don’t eat properly and are more likely not to exercise. They are also non-compliant when it comes to taking their medications to control such things as high blood pressure or diabetes, which are two major risk factors for heart disease.”

As a result, they are at increased risk of having another heart attack and “quite possibly dying,” noted Wassif, as well as being readmitted to the hospital and slowing down their ability to return to better health.

While screening for depression is more likely to occur in the primary-care setting, as opposed to at the cardiologist’s office, she said it is something that cardiologists need to address should a patient open up to them about feeling depressed. “Helping them to get appropriate treatment will vary from simply talking with a behavioral-health professional to taking antidepressant medicines.”

To learn more about Baystate Medical Center’s life-saving cardiac capabilities, visit www.baystatehealth.org/bhvp.