Recent findings from two studies strengthen the evidence linking depression and heart disease. Researchers also found that patients who were physically inactive were more likely to experience depression than those who exercised regularly.
Physical activity is a key factor in fighting both depression and heart disease. It also helps patients better prepare for heart surgery and recover more quickly afterward.
The evidence suggests that exercise is one of the most powerful tools in lessening the mental and physical effects of heart disease as well as being one of the most basic tactics for controlling depression.
In an 11-year study, Norwegian researchers followed the health history of 63,000 subjects. The study found that moderate to severe depression raised subjects’ risk of heart failure by 40 percent. The researchers presented the findings at EuroHeartCare, the annual meeting of the Council on Cardiovascular Nursing and Allied Professions (CCNAP) of the European Society of Cardiology (ESC).
Though scientists aren’t sure exactly why depression greatly increases risk for your heart, they theorize that the stress that often accompanies depression increases inflammation in the body. Inflammation can lead to atherosclerosis, or clogging of the arteries, and cardiovascular disease.
A depressed person might also have more difficulty in taking important medications and following medical instructions consistently, such as working to improve diet and exercise.
The second study, Impact of Physical Activity on Depression After Cardiac Surgery (IPAD-CS) published in the Canadian Journal of Cardiology, studied possible factors that cause depression in 40 percent of patients who undergo cardiac surgery.
Researchers assessed 436 patients and found that those who were physically inactive before surgery were twice as likely to have symptoms of depression before undergoing heart procedures.
Lack of physical activity contributed to increased risk for new depression six months after surgery and stress also increased risk for depression following surgery.
Both studies found strong associations between lack of physical exercise, depression and heart disease but neither proved any cause and effect.
No one knows if depression leads to physical inactivity, or if physical inactivity leads to depression, but it is clear that physical activity helps mediate both anxiety and depression, and that it improves quality of life for heart patients.
The American Heart Association (AHA) released an updated statement in 2014 strengthening an earlier statement that said people with depression fare worse after an acute heart event. The AHA went further, saying that depression should be officially considered a risk factor for people with acute coronary syndrome.
Depression, inactivity and heart disease form an unhealthy alliance — a heart-toxic cycle that merits intervention and more study.
Leo Pozuelo, MD, Section Head of Consultation Psychiatry at Cleveland Clinic, studies the mind-heart connection. “Patients should take stock of their emotional well-being. If you have had previous signs of depression, or if new ones develop, make sure you talk with your doctor,” he says.
Dr. Pozuelo adds that you should also watch out for other types of mental health conditions. “Anxiety can also be cardio-toxic, so it is important to learn how to deal with stress. The interventions that improve your heart health, such as a healthy diet and exercise, are also great for helping reduce anxiety, so you can accomplish two goals with one wellness initiative,” he says.
An organized rehab program helps heart patients even more than informal exercise. A 2016 meta analysis published in the Journal American College of Cardiology concluded that cardiac rehabilitation programs reduce cardiovascular mortality and hospitalizations as well as improve quality of life.
Recently, Medicare acknowledged cardiac rehab’s benefits by expanding its coverage of services to include a larger pool of cardiac patients. Talk with your physician to find out which program best fits your needs.