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Depression, Heart Failure Closely Linked

Nearly Half of Heart Failure Outpatients May Suffer From Depression

WebMD Health News

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 blacks)

  • 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 like."

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.

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