April 14, 2004 -- Prescription for a healthy heart: Bond with a close friend. Regular doses are required.
A close relationship may reduce your risk of having a second heart attack -- possibly even a first attack, a new study shows.
"A close confidant is someone you can share all your concerns with, it's more than just having someone to talk to," researcher Francis Creed, MD, a psychiatrist and professor of psychological medicine at Manchester Royal Infirmary in Great Britain, tells WebMD. His study appears this month in the British medical journal Heart.
Helene Glassberg, MD, director of preventive cardiology at Temple University School of Medicine in Philadelphia, concurs. "Taking care of yourself on a physical level is important, but mental health is important, too," she tells WebMD. "Having a confidant lowers stress, and it improves one's sense of well-being. It may lower blood pressure and levels of stress hormones, even increase hormones, like dopamine, which have a calming effect."
The Heart of the Issue
Previous studies have pointed to depression as a predictor of heart attack and death from a heart attack. This study investigated the issue of social support a bit deeper.
In their study, Creed and his colleagues focused on 583 men and women, all about age 60, all who were hospitalized with heart attacks.
Along with heart function and blood pressure tests, each patient was asked about emotional issues -- their psychiatric history, whether they had been separated from parents in childhood, and what social support they had. The patients also took tests to determine whether they were anxious or depressed.
Researchers checked back with them one year later.
Patients had 50% less risk of dying from heart disease within the year of their initial hospitalization for a heart attack if they had a close personal confidant. Those without a close confidant were more likely to have had a prior history of a heart attack and to have been smokers. They were more likely to have more severe heart attacks and more complications related to the heart attack. They also were more likely to drink heavily, use illegal drugs, and smoke.
Emphasis on 'Close' Is Important
It's the degree of intimacy of close relationships -- not the number of social contacts -- that appears to protect heart health, Creek explains.
A close confidant is "usually a spouse or partner, but not necessarily," he tells WebMD. "It may be a very, very close friend or relative."
"When we think about prevention of heart disease, it's usually about physical factors, like lowering blood pressure, cholesterol, fat, and getting exercise," Creek says. "But there's a very important emotional component that comes into play also. Treating depression and helping people get social support, are new ways to help people prevent heart disease or more heart attacks."
"Each influences the other," says Glassberg. "If your mental health is good -- whether it's because you don't have depression or because you have a confidant who listens to you -- it's very likely you will have less stress, and that is certainly a good thing."
Even though depression was not linked with heart attack in his study, doctors and patients should not ignore it, writes Creek. After all, depressed people as well as those without a close confidant are less likely to give up smoking after a heart attack. They may also delay getting help after a possible heart attack.