Whether depression is an independent risk factor for coronary heart disease is a million dollar question that has remained unanswered.
There is enough evidence to associate depression and heart disease however it is still not been given the weightage it deserves to be called a risk factor. Despite the strong evidence the field is still being actively explored.
AdvertisementMental disorders and coronary heart disease are significant public health issues that add up to the global disease burden. The Global Burden of Disease (GBD) Study estimates the premature mortality and disability of all major diseases and injuries. A GBD study undertaken in 2001 showed that the psychiatric condition called unipolar depressive disorders as the third leading cause of disease burden. Ischemic heart disease Coronary heart disease (CHD) or coronary artery disease is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also, a condition where the blood supply of the heart muscles get compromised, ranked fourth globally and second in high and middle-income countries in terms of global disease burden.
The links between mental disorders and cardiovascular disease have been investigated for many decades. Depression has various direct and indirect biological effects which may explain its link with cardiovascular disease. A number of behavioral pathways have also been identified in the link between mental disorders and cardiovascular disease.
The following are some of the factors that support the behavioral pathways:
• Patients who suffer from a mental disorder are less likely to adopt a healthy lifestyle or to reduce cardiovascular risk factors.
• Physical activity and diet control are less frequently undertaken and smoking and alcohol consumption rates are often higher.
• Obesity has been strongly associated with both cardiovascular disease and mental disorders such as depression, bipolar disorder and panic disorder.
• Adherence to treatment is often less in depressed patients compared to non-depressed patients.
• Depressed patients are known to access social services less frequently and insufficient social support has been strongly linked to the development of cardiovascular disease.
CHD is a broadly defined term. It is known that the association is stronger with MI, i.e. Myocardial Infarction (heart attack). The latest article published in Biomed Central, an authentic publisher of open access journals, explores deeper into the associations.
Authors claim that, 'there is sufficient evidence to recommend that Burden of Disease estimates should include MDD as a risk factor for CHD, and this evidence is strongest for CHD resulting in MI'.
Further research is called upon to clarify the nature of this relationship. It is vital however that further awareness is raised about major depression as a risk factor for CHD. The authors appeal for the inclusion of major depression as a risk factor for CHD in the 2010 GBD study.
Source: BioMed Central