Heart Disease Tied to Depression, Anger
Chronic Anger, Hostility, or Major Depression May Increase Likelihood of Heart Disease, New Studies Show
Heart Disease, Depression, Anger continued...
Williams tells WebMD that he "absolutely" considers chronic anger, hostility, or depression to be risk factors for heart disease, just like high blood pressure (hypertension), smoking, or high cholesterol.
Based on the new reports and previous research, "I think you pretty well have to conclude that yes indeed, these are risk factors," Williams says.
"The biggest message that we try to get out to people is this is a risk factor and a health problem," Binkley says. "This is something we have to talk about. The worst thing is to ignore it."
Cardiologist Pamela Douglas, MD, Geller Professor of Medicine at Duke University, also sees a strong link between depression and heart disease -- but she stops short of calling depression a risk factor for heart disease. She says it's not clear which comes first, depression or heart disease. "It's sort of a chicken-or-the-egg issue," Douglas says.
All three experts agree that other heart disease risk factors often accompany depression -- and it never hurts to screen for heart hazards. And if you already know you have heart disease, you should be screened for depression, according to guidelines set in September 2008 by the American Heart Association.
What About Antidepressants?
As noted earlier, the new report on depression and heart disease showed a possible link between antidepressant use and the risk of sudden cardiac death.
Those findings raise more questions than they answer.
"The question is, is that just because the antidepressants were a sign of a more severe depression or was it a result of something about the antidepressants themselves?" Williams asks.
Williams notes that some antidepressants, called tricyclic antidepressants, are known to have possible effects on cardiac arrhythmias. But the new report doesn't show what kind of antidepressants the patients were taking or other details about their antidepressant use.
"It could be that the drug itself was contributing to the risk of sudden cardiac death in patients who were depressed ... but my guess would be that it's probably, if anything, a function of the severity of the depression," Williams says.
Binkley says that people taking antidepressants shouldn't jump to conclusions. "We need to collect much more information. This is one study," says Binkley.
Douglas agrees that the antidepressant findings aren't totally clear. But she says, "Don't take 'em if you don't need 'em."