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Heart Watch Blog: Why Depression Causes Poor Outcome In CAD?

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Dec 2, 2005

Why Depression Causes Poor Outcome In CAD?

Why Depression Causes Poor Outcome In CAD?
What's the link between depression and poor outcome in coronary artery disease? That's the topic of interest for Mary Whooley, MD at the San Francisco VA Medical Center. Her study suggests two possible mechanisms for the widely recognized link between depression and adverse outcomes in patients with coronary heart disease: lack of adherence to medication regimens and increased levels of norepinephrine, a stress hormone.

"Patients with depression are more likely to suffer heart attacks and heart failure, and more likely to die of heart disease, and no one knows why," says Whooley "These results give us two intriguing clues: one behavioral, one biological."

One of her studies looked at the association between depression and self-reported medication adherence in 940 patients with stable coronary heart disease, 204 of whom had diagnosis of depression. Fourteen percent of the depressed patients reported not taking their medications as prescribed over a 30-day period, compared with 5 percent of the non-depressed patients. This study appears in the November 28 issue of Archives of Internal Medicine.

Another study examined 24-hour urinary norepinephrine levels in 598 coronary disease patients, 106 of whom had depressive symptoms. A total of 9.4 percent of the depressed participants had a urinary norepinephrine value above the normal range, compared with 3.3 percent of the non-depressed participants. In addition, the more depressive symptoms a participant had, the higher the participant's norepinephrine levels. This paper appears in the November 2005 issue of the American Journal of Psychiatry.

Neither study indicates a mechanism for adverse coronary outcomes "because we were only looking at cross-sectional data," stresses Whooley, who is also an associate professor of medicine at the University of California, San Francisco.

Daniel      


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Heart disease
About 13 million Americans (about 7 percent of the total population) suffer from coronary artery disease. Coronary artery disease is the leading cause of death in American men and women amounting a staggering 20 percent of all causes of death. About half of all deaths related to cardiovascular diseases occur from coronary artery disease. Through this heart watch blog we will have our humble contribution towards making men and women aware of the risks of heart diseases.

Heart Watch Blog: Why Depression Causes Poor Outcome In CAD?

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