It's also possible that biological changes associated with depression such as reduced heart rate variability and increases in blood factors that encourage clot formation could increase risk, the statement said.
Other recommendations in the statement include:
-- Patients who have depressive symptoms should be evaluated by a
professional qualified in diagnosing and managing depression, and should
be screened for other psychiatric disorders, such as anxiety.
-- Treatment options include cognitive behavioral therapy, physical
activity, cardiac rehabilitation, antidepressant drugs or combinations
of those treatments.
-- Selective serotonin reuptake inhibitor (SSRI) treatment soon after a
heart attack is considered safe, relatively inexpensive and may be
effective for treating depression.
-- Routine screening for depression in coronary heart disease patients
should be done in multiple settings, including the hospital,
physician's office, clinic and cardiac rehabilitation center, to
avoid missing the opportunity to effectively treat depression in cardiac
patients and improve physical health outcomes.
-- Coordination of care between health providers is essential for patients
with combined medical and psychiatric diagnoses.
"Depression and heart disease seem to be very much intertwined," Lichtman said. "You can't treat the heart in isolation from the patient's mental health.
"There is no direct evidence yet that treating depression improves
coronary heart disease outcomes, but plenty of evidence shows that having
depression worsens those outcomes. By understanding the prevalence of
depression and learning more about the subgroups of heart patients at
particular risk of depression, we can begin to understand the best ways
|SOURCE American Heart Association|
Copyright©2008 PR Newswire.
All rights reserved