AP Medical Writer
WASHINGTON — Severe depression may silently break a seemingly healthy
woman's heart.
Doctors
have long known that depression is common after a heart attack or stroke, and
worsens
those people's outcomes. Monday, Columbia University researchers reported new
evidence
that depression can lead to heart disease in the first place. The scientists tracked
63,000
women from the long-running Nurses' Health Study between 1992 and 2004. None
had
signs of heart disease when the study began, but nearly 8 percent had evidence
of
serious
depression.
The
depressed women were more than twice as likely to experience sudden cardiac
death
— death typically caused by an irregular heartbeat, concluded the 12-year
study,
published
Monday in the Journal of the American College of Cardiology. They also had
a
smaller increased risk of death from other forms of heart disease. The big
surprise:
Sudden
cardiac death seemed more closely linked with antidepressant use than with
the
depression symptoms the women reported. That might simply mean that women
who
used antidepressants were, appropriately, the most seriously depressed,
cautioned
lead
researcher Dr. William Whang. But he said the finding merited more research.
Studies
of the newer antidepressants most often used today so far haven't signaled a
risk
of irregular heartbeat, and some even have suggested protection, noted Dr.
Redford
Williams
of Duke University, a specialist in how psychosocial factors affect health.
The
drug question aside, Williams said the work adds to growing evidence that
depression
is an independent risk factor for heart disease — on top of the classic
risks
of high blood pressure, diabetes, high cholesterol and smoking. The
predominantly
white
Nurses' Health Study may underestimate it, Williams said. "If anything,
the impact
in
African-American women is probably greater," he said, adding that it's
time for the
next
step: A study testing whether properly treating depression lowers the
risk. Why
might
depression have that effect? The study found that the more severe the women's
reported
depression symptoms, the more likely she was to have traditional heart risk
factors.
Also, stresses like depression have been linked to such physical effects as a
higher
resting heart rate. Perhaps a more straightforward reason: Depression can make
people
do a worse job taking care of themselves. Indeed, the American Heart
Association
last
year recommended that everyone who already has heart disease be regularly
screened
for
depression — because depressed patients may skip their medications, sit indoors
instead
of exercising, and eat particularly poorly