Depression, Heart Failure Closely Linked
Nearly Half of Heart Failure Outpatients May Suffer From Depression
May 4, 2004 -- Depression may be a major problem among people
with heart failure, even if they aren't in the hospital. A new study suggests
that nearly half of all people being treated for heart failure on an outpatient
basis may suffer from depression.
Researchers found 48% of heart failure outpatients given
questionnaires measuring quality of life and depression scored as being
depressed, and their depression was negatively affecting their quality of life
and ability to exercise.
Previous studies have shown up to three-quarters of
hospitalized heart failure patients suffer from depression, but researchers say
this is the first major study to look at how common depression is among stable
outpatients with heart failure.
The results appear in the May 5 issue of the Journal of the
American College of Cardiology.
Depression Tied to Heart Failure
Researchers say depression may have a major impact on the
quality of life of people with heart failure, and depression has been linked to
more frequent hospitalization, increased medical costs, and higher death rates
among people with heart failure.
To determine the prevalence of depression among
non-hospitalized heart failure patients, researchers surveyed 155 people with
stable heart failure about their quality of life and depression.
The study showed that 48% of the heart failure outpatients
scored as depressed according to standardized questionnaires. Depressed
patients tended to be:
- Younger than non-depressed patients
Women (64% of women were depressed vs. 44% of men)
White (54% of whites were depressed compared with 34% of
Less likely to be receiving a beta-blocker
More likely to have worse physical functioning
Depressed heart failure patients also scored much worse on all
measures of quality of life. But they were not significantly sicker than their
non-depressed counterparts. Both depressed and non-depressed heart failure
patients had similar ejection fractions, a measure commonly used to indicate
heart failure severity.
"Depression is probably very important both in evaluating
patients with heart failure and in affecting how they feel," says
researcher Stephen S. Gottlieb, MD, of the University of Maryland School of
Medicine in Baltimore, in a news release. "And unless we deal with their
depression, we can't improve the symptoms of these patients as much as we would
In an editorial that accompanies the study, Christopher M.
O'Connor, MD, and medical student Karen E. Joynt of Duke University Medical
Center, say the results of the study call for screening heart failure patients
for depression and treating it when found.
"This represents a major, and largely overlooked,
contributor to the poor prognosis of heart failure patients in the
community," write the editorialists.