Does depression increase death risk in patients with coronary heart disease?

This study investigated if there is a link between depressive symptoms and sudden death in patients with coronary heart disease (CHD). They found that patients with depressive symptoms have a higher risk of sudden cardiac death.

Coronary heart disease (CHD) is caused by reduced blood flow to the heart. There are a number of factors that lead to CHD. These include blockages in the arteries or defects in the valves of the heart. Patients with CHD also have a greater risk of clinical depression (CD). CD can lead to feelings of sadness, tiredness and reduced quality of life.

Some evidence suggests that depressive symptoms are associated with an increased risk of death in patients with CHD. Sudden cardiac death (SCD) is a specific form of death caused by sudden changes in heart rhythm. It is unclear if depressive symptoms in patients with CHD is linked to the risk of SCD. 

This study included 1,928 patients with stable CHD. Patients in this study were followed for an average of 6.3 years. A number of risk factors were monitored during the trial. This study reports the findings on depressive symptoms. Patients were asked to complete a questionnaire on depression. The risk of SCD was recorded.

Overall, there were 5% deaths due to heart disease. Of these, SCDs accounted for 50% of cardiac deaths. Patients with higher depression scores were more likely to experience SCD than patients with lower scores. Patients with the highest depression scores were 4 times more likely to experience SCD than patients with the lowest scores. A lack of exercise was the most powerful predictor of SCD in this trial. 

The authors concluded that patients with CHD who depressive symptoms have a higher risk of sudden cardiac death. The authors suggest that more attention should be given to the evaluation and treatment of depressive symptoms in these patients.

It is unclear what links depressive symptoms and SCD. The authors also found that moderate physical activity reduces SCD risk significantly. Further investigation into the link between depressive symptoms, exercise, and SCD is needed.

If you have any concerns about CHD and depression, please consult with your doctor.