According to a new study, people with heart failure have a significantly increased risk of death if they suffer from moderate or severe depression.
Heart failure is already a life-threatening condition which leads to the heart muscle being unable to pump enough blood around the body. The symptoms include tiredness, shortness of breath, dizziness and swollen ankles.
According to researchers, it is already established that people with heart failure have a high risk of recurrent hospital admissions and death.
"Approximately 25% of patients admitted to hospital with heart failure are readmitted for a variety of reasons within one month. Within one year, most patients will have had one or more readmissions and almost half will have died," says lead researcher, John Cleland of Imperial College London.
Cleland and his colleagues conducted the ongoing study to assess the main reasons for hospital readmission and death among patients with heart failure.
"This included social, mental and physical frailty, as well as comorbidities and the severity of heart failure. Depression has been reported to predict death in patients with heart failure but until now it was thought that this could be because depressed patients have more severe heart failure and more comorbidities," Cleland says.
An analysis of over 150 patients found that those with moderate to severe depression were five times more likely to die compared to those with no depression or mild depression. These results remained even after researchers took into account other factors such as age, high blood pressure and the severity of heart failure.
"Our results show that depression is strongly associated with death during the year following discharge from hospital after an admission for the exacerbation of heart failure. We expect that the link persists beyond one year" Cleland says.
Cleland also pointed out that depression is quite common among people with heart failure, often affecting between 20 percent and 40 percent of patients.
"Depression is often related to loss of motivation, loss of interest in everyday activities, lower quality of life, loss of confidence, sleep disturbances and change in appetite with corresponding weight change. This could explain the association we found between depression and mortality."
Professor Cleland was quick to point out, however, that he was not in favor of automatically prescribing anti-depressants.
"Studies suggest that they are not effective in reducing depression in patients with heart failure. Clinicians should, however, screen patients with heart failure for depression and consider referring those affected for counselling," Cleland says. "More research is needed to find out what clinicians and patients themselves can do to manage depression. Better treatments for heart failure, co-morbidities as well as depression itself may be required."
