Depression and stress in patients with type 2 diabetes: can they affect outcomes following a heart attack or stroke?

This study examined whether depressive symptoms and stress have a negative impact on cardiovascular outcomes in patients with type 2 diabetes. The authors concluded that both depressive symptoms and stress increase the risk of worse cardiovascular outcomes in type 2 diabetes.

Cardiovascular disease (CVD) is the narrowing or blockage of blood vessels. Outcomes of CVD include stroke, a heart attack or death. Many factors influence cardiovascular (CV) outcomes in patients. It is thought that patients with type 2 diabetes (T2D) who experience depression or stress may have a poorer CV outcome.

This study aimed to determine the association between depression and/or stress and CV outcomes in patients with diabetes.

This study involved 22033 participants. Participants were divided into two groups. 4090 participants had diabetes, while 17943 participants did not. Depressive symptoms and/or stress were determined for each individual. Participants were followed for an average of 5.95 years and the number of participants who experienced a stroke, heart attack or death was recorded.

Depressive symptoms and/or stress were more common in T2D patients (36.8%) compared to those who did not have T2D (29.5%).

T2D patients with depressive symptoms and/or stress had a higher risk of having a stroke (57%), while participants who did not have T2D did not have an increased risk. T2D patients with depressive symptoms and/or stress had a higher risk of mortality following a CV event (53%), while participants who did not have T2D did not.

T2D patients who had a combination of depressive symptoms and stress had 2.15 times the risk of mortality following a CV event than did participants who did not have T2D.

This study concluded that a combination of stress and depression is associated with a worse CV outcome in T2D patients.

Additional factors, such as diabetes duration, were not taken into account. Diabetes duration may affect CV outcome. This study also only included non-Hispanic white and blacks. Therefore, it is not known whether these results would also be seen individuals of another race.

Consult your physician regarding the options available if you suffer from depression or stress.