Women
more likely to develop anxiety and depression after heart attack
Women are more
likely to develop anxiety and depression after a heart attack (myocardial
infarction; MI) than men, according to research presented at Acute
Cardiovascular Care 2014 by Professor Pranas Serpytis from Lithuania.
Acute
Cardiovascular Care is the annual meeting of the Acute Cardiovascular Care
Association (ACCA) of the European Society of Cardiology (ESC) and takes place
18-20 October in Geneva, Switzerland.
Professor
Serpytis said: "The World Health Organization predicts that by 2020
depression will be the second leading cause of disability and mortality in the
world, surpassed only by ischaemic heart disease. Major depression follows MI
in approximately 18% of cases and is an important predictor of disability and
poor quality of life in the year post-MI."
He continued:
"Patients with depression are nearly 6 times more likely to die within 6
months after an MI than those without depression. The increased risk of death
in patients with depression persists up to 18 months after the MI. But despite
the fact that post-MI depression is common and burdensome, the condition
remains under-recognised and undertreated."
The current
study investigated the impact of gender and cardiovascular disease risk factors
on the risk of developing depression and anxiety after an MI.
The study
included 160 patients admitted with a myocardial infarction to the Vilnius
University Hospital Santariskiu Clinics in Vilnius, Lithuania. Patients were
interviewed at least 1 month after the MI to collect information on demographic
(including sex, age, education, marital status) and clinical characteristics
(incidence of diabetes mellitus, previous treatment for hypertension, previous
MI), other cardiovascular disease risk factors (smoking, physical activity),
and history of mental health issues.
Depression and
anxiety were both assessed using the Hospital Anxiety and Depression Scale
(HADS): no depression and anxiety (0-7 score), possible depression and anxiety
(8-10 score), mild to moderate levels of depression and anxiety symptoms (11+
score).
The researchers
found that nearly one quarter of patients in the study were depressed (24.4%)
and of those, 28.2% had received treatment with antidepressants (p<0 .05="" 3.7="" 6.87="" 7.18="" 8.20="" 8.66="" and="" anxiety="" average="" depression="" for="" hads="" in="" mean="" men="" o:p="" p="" score="" the="" was="" women="">0>
Professor
Serpytis said: "We found that women were more likely to develop anxiety
and depression after a heart attack than men. More research is needed to
discover the possible reasons for this."
The researchers
also found an association between anxiety and smoking. In the study, 15.6%
patients were current smokers and their mean HADS score for anxiety was 10.16
(±4.9). An additional 77.5% of patients had never smoked and their mean HADS
score for anxiety was 7.3 (±4.1), while the 6.9% patients who had quit smoking
more than 2 years ago had a mean HADS score for anxiety of 4.55 (±3.7)
(p<0 .05="" o:p="">0>
Professor
Serpytis said: "Current smokers were more likely to have anxiety after an
MI than never smokers or people who had quit smoking more than two years ago.
We did not find any association between smoking and depression after an
MI."
Physically
inactive patients tended to be depressed, with a mean HADS score of 8.96
(+4.1). Overall, 64% of patients with depression said they were not physically
active (p<0 .05="" o:p="">0>
Professor
Serpytis said: "Women are misrepresented in many clinical studies on MI
even though they often have worse outcomes. Our study shows that women are more
likely to develop anxiety and depression after MI than men but until now this
issue has been largely unnoticed. Clinicians should assess MI patients,
particularly women, for anxiety and depression so that timely treatment can be
started."
He concluded:
"Our study suggests that encouraging patients to quit smoking and increase
their physical activity levels should reduce their risks of anxiety and
depression after MI. More research is needed on the links between myocardial
infarction and mental health problems."
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