What's The Connection Between Depression And Heart Disease?
"It's not uncommon for people who undergo bypass surgery for heart disease to also deal with depression. And the reverse is also true as well. People with depression are at higher risk for heart problems. That linkage is the focus of a new study by Dr. Bruce Rollman, a professor of medicine at the Pittsburgh School of Medicine."
Lewis: People with heart disease seem to have a higher risk for depression. How are these two problems connected?
Dr. Rollman: That's a great question. Nobody exactly knows. There have been a number of studies that show that even young adults who are depressed are at higher risk of developing heart disease and sooner than similar young adults who are not depressed. In addition, patients who do have heart disease—whether it's post bypass, heart failure, after a heart attack or so on—if they do have what's called comorbid depression, or depression in combination with their cardiac condition, these patients have been shown across numerous studies to do much worse than similar patients with heart disease but no depression.
Lewis: In your new study, you look at people who had depression after undergoing bypass surgery for their heart disease. And researchers found that at least 30 percent of people are depressed leading up to the surgery or afterwards, so what other factors aside from having heart disease, might be causing the depression here?
Dr. Rollman: Nobody knows. There's been, as you mentioned when quoting the figures, people have assessed patients before surgery and after the surgery and find approximately similar rates of depression before and after, but the precise people might differ. Some patients might be depressed before surgery but not depressed after, and vice versa. Regardless, there have been numerous studies that show if you do have depression after bypass surgery, those patients take longer to recover; they express more pain after the bypass surgery; they take more time to return to work and their usual activities. We published the main outcomes from an NIH-funded trial that we conducted between 2003 and 2008 in the Journal of the American Medical Association. In 2009, in that paper, we reported that intervention provided by nurses could significantly speed recovery as well as reduce pain. We even found trends towards reduction in rehospitalization after bypass. Our latest paper that was just published reports our analysis of Medicare data as well as other insurance claims data that found that patients in our bypass study were randomized at the intervention generated about $2,000 less cost in the following year of bypass surgery than the patients who were randomized to the usual care control condition.