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Depression and heart disease: A new study examines the possibility of a link

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People have been fascinated for generations by the connections between mind and body. For example, is it possible to die from a broken heart? Is a healthy mind indicative of a healthy body?

For a long time, scientists have studied the links between mental and bodily health. Depression and heart disease are two examples of such a link. For example, research shows that people with heart disease are more likely to experience depression than the general population.

Furthermore, people with high levels of depression are more likely than those without to develop heart disease if they are followed for a long time.

Aside from the fact that people suffering from acute heart disease (for instance, a heart attack) are more likely to develop depression, there is also a higher risk of death from any type of heart disease.

But, fewer studies have examined whether these trends can be reversed – that is, whether cardiovascular risk factors and depression are related. A new study published in PLOS ONE explores this question.

What the researchers did

Sandra Martin-Pelaez, University of Granada, Spain, and her colleagues looked at people with metabolic syndrome. In addition, they wanted to investigate the relationship between cardiovascular risk factors for depression and people between 55 and 75 years old.

Metabolic syndrome is a combination of conditions, including high blood sugar, hypertension, excessive body fat around your waist, and high cholesterol. These conditions increase the risk of developing heart disease, stroke, and type 2 diabetes. In addition, researchers have suggested that metabolic syndrome could play a part in depression.

Participants in this study were selected from a larger trial that examined the effects of Mediterranean diets on overweight and obese people with metabolic syndrome. One group followed a Mediterranean diet with a restricted calorie intake and exercise program, while another followed a Mediterranean diet that did not include a physical program.

Over 6,500 people were part of the baseline analysis for PLOS ONE. More than 4,500 participants were followed up two years later. Researchers used the well-known Framingham risk score to identify the main risk factors for heart disease. This score was derived from a long-term study of healthy individuals. The researchers classified people into low, medium, and high risk of having a heart attack or dying from it within ten years.

Participants completed questionnaires to assess their depression at baseline (when they started following the diets and two years later).

Surprisingly there was no association between depression and cardiovascular risk at baseline or during follow-up. Furthermore, participants with higher heart disease risk were not more likely than others to develop or have depression.

The authors looked at the data by gender and found that women with higher cardiovascular risks were more likely than others to experience symptoms of depression. This was not true for men, which wasn’t the case at follow-up.

All participants saw a decrease in their depression scores after two years. Participants with low cardiovascular risk and those in the intervention group (participants following a restricted diet and a physical activity program) had lower depression scores.

The results of this study are difficult to understand. There are mixed results from the analysis of the data. The authors examined the data using different metabolic syndrome factors. They found that certain cholesterol levels and diabetes resulted in lower scores for depression at follow-up.

Other research has shown that women suffering from heart disease are more likely to experience depression than their male counterparts. It is also known that women are more likely to experience depression than men in general. These trends seem consistent with the findings that women may be at higher risk for heart disease and have more depression than men.

What is the connection between heart disease and depression?

While we cannot conclude that heart disease is linked to a greater risk of developing depression from this study, it adds to a strong body of evidence that suggests heart disease and depression may be interrelated.

This relationship may be explained by a variety of biological and behavioral factors. These biological factors are common to both heart disease risk and depression:

  • Inflammation has increased
  • endothelial dysfunction is a condition that causes blood vessels to narrow in the heart.
  • Activity in the altered autonomic nerve system (the autonomic system controls muscles and the heart)
  • Blood platelet dysfunction is where blood platelets stick together more and form clots.

We also know that healthy lifestyle factors such as not smoking and engaging in physical activity are good for heart health. Conversely, neglecting to live a healthy lifestyle is associated with a higher risk of developing heart disease and depression.

People with depression have a harder time changing these habits, such as quitting smoking, than others. However, the most striking finding from this study was that people with depression had lower scores when encouraged to live a healthier lifestyle. This included a stricter diet and more physical activity.

There is good evidence that exercise can be a very effective treatment of depression in patients with heart disease. However, it is not clear if diet can also be used to treat depression. This study offers a positive impetus to further investigate diet and lifestyle as possible depression treatments for those who have or are at risk of developing heart disease.

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