Health Topics

Healthy Living

April 2011
Depression and Heart Attack
Dr. Rakesh Gopal
 

You feel you are lonely,
No one around seems interesting,
Feel nothing is worthwhile.
Your family, friends and colleagues are all so taxing Feel you could get away from them.
Your daily chores are so disgusting,
You would rather curl up in bed than set out.
Well, you have clinical depression!
It is trouble -
Your heart too is at stake.

Recent research has found that depression can lead to heart attacks. Scientists knew this since the '80s. Now though, it is proven beyond doubt quantitatively. Why and how depression leads to heart attacks is not entirely established. But what is known is, depressed people tend to smoke more, consume excess alcohol, exercise less, are more stressed and are less likely to take any kind of medication, including cardiac drugs.

Biologically, depression increases the production of free radicals, free fatty acids, the cytokine TNF Alpha (Tumour Necrosis Factor Alpha) which could damage
arterial linings and predispose to heart attacks.

Higher Risk
Women, elderly, those who live alone and lack family support are more likely depressed. A study done at Wake Forest University, USA, in 4500 elderly people showed those who had signs of depression were at 40 percent higher risk for heart attacks. Another study from Baltimore placed depressed people of all ages at four times risk of heart attacks in the ensuing 14 years. Research now identifies depression as much a risk factor for heart attacks - as high blood pressure and high cholesterol are!

A big problem with depression is that it is mostly not diagnosed. Depression, stress and anxiety are good friends. Type D personality - in simple terms, those in distress - are largely sleep deprived, tend to have high blood pressure, high insulin levels, cholesterol, sympathetic tone and high cortisol levels.

How can you help yourself?
There are many theories and speculation, but hard core biological evidence that depression causes heart attacks, and treating depression reduces heart attack mortality is still lacking. But cardiologists who treat heart attacks are not geared up to diagnose or treat depression, despite their expertise in treating conventional cardiac risk factors.

Now that you know these facts, if you think you are depressed, talk to someone who can help. Don’t keep it to yourself. It is smouldering fire. Don’t get isolated. Make sure nothing is wrong with you, if you think everyone and everything around you is wrong and the whole world is unjust to you. Engage in some kind of reasonable and sustainable physical activity. The new generation anti depressants are quite heart friendly unlike the older drugs. Take care.
 

Dr. Rakesh Gopal is Consultant Cardiologist at Apollo Hospitals, Chennai
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