Coronary heart disease

  • European guidelines on cardiovascular disease prevention41describe that
    • Depression predicts cardiovascular events and worsens prognosis;
    • Depression at least doubles the risk of a major cardiac event;
    • In patients with CHD, depression has effects on cardiac symptoms, overall quality of life and illness behaviour including increased healthcare utilisation, low adherence to treatment and lowered rates of return to work.
  • People who have suffered a heart attack, unsurprisingly, have a 30 per cent chance of developing depression – which can be helped in its own right.30
  • Those with cardiac problems are approximately three times more likely to die of these causes if they also suffer from depression than if they do not.31
  • Depression in people with CHD predicts further coronary events (odds ratio = 2.0) and greater impairment in health-related quality of life.24-25
  • People who develop depression following acute coronary syndrome, as opposed to those with depression that pre-dates the acute coronary syndrome, may be at particularly high risk of worse cardiac outcomes.31
  • Depressed individuals with CHD are more than twice as likely to die as those with CHD alone.24 25 The mechanisms behind the association between depression and either mortality or morbidity in physical illness are not fully understood.33 Either diminished healthcare behaviour or physiological impairment, or a combination of the two, may be important.