Study participants were more than 2,500 primary care patients aged 60 or older who were free of cardiovascular disease at study onset. They were screened for four clusters of depressive symptoms—depressed affect, somatic symptoms, interpersonal problems, or lack of positive effect—with the Center for Epidemiologic Studies Depression Scale. The subjects were followed for 15 years to determine whether any experienced a heart attack; a total of 678 did. The researchers then assessed whether any of the four clusters of depressive symptoms could have predicted a heart attack, after adjusting for various cardiovascular risk factors and for presence of the remaining clusters. They found that somatic symptoms of depression were a risk factor for heart attack in their study population.
"Our results...could inform the development of interventions designed to simultaneously treat depression and reduce coronary artery disease risk among older men and women," the researchers concluded. "Such interventions should have demonstrated efficacy for the somatic symptoms of depression, particularly reduced appetite and fatigue, if cardiovascular benefits are to be expected. Existing depression interventions that may be good candidates and worthy of further evaluation include appetite-stimulating antidepressants, such as mirtazapine, and exercise training."
More information about the complex relationship between depression and cardiovascular disease can be found in the Psychiatric News articles "Red Blood Cell Size Linked to Depression in Heart-Disease Patients," and "Depression-Cardiovascular Link Found in Young Adults." Also see the study, "Comprehensive Meta-Analysis of Excess Mortality in Depression in the General Community..."published January 17 in AJP in Advance.
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