Depression and Cardiovascular Disease: The Connection That Can Break Your Heart

It’s not exactly news: Heart disease and depression, two of the most common chronic conditions in America, are also linked to each other. Researchers, who have been looking at the connection for decades, know that at least one-fourth of all heart disease patients have depression – many are clinically depressed following a stroke, heart attack or bypass surgery.

They also know that having depression increases men’s risk for heart attack by 60 percent and women’s risk of stroke by 44 percent.

Why are the two linked? Let’s start with depression first. People who are depressed may:

• Drink alcohol or eat excessively;
• Smoke or take illicit drugs;
• Skip exercise;
• Feel additional stress;
• Skip medications.

These actions can up the risk for factors that contribute to heart disease, such as high blood pressure, high cholesterol and obesity. And there may be other factors, such as an intense focus on past traumatic events, that can harm the heart, researchers theorize.

Individuals with heart disease may feel depressed when symptoms cause life changes or after a heart attack or surgery. For people who have suffered a major cardiac event, such as a heart attack or stroke, up to 40 percent meet the criteria for major depressive disorder. Another study found that 27 percent of patients undergoing bypass surgery had depression after the surgery. Other studies show the impact of these feelings—depression may slow recovery efforts or even lead to another cardiovascular event.

Researchers also haven’t ruled out that the two conditions may share underlying causes, with symptoms of psychological distress often appearing before the symptoms of heart disease. Both conditions are considered serious limiters on longevity, with heart disease the number one cause of death in the U.S. And when the two diseases affect the same person, their lifespan prognosis is much worse.

The Role of Happiness in Heart Disease
While depression and heart disease are linked, so are good health and happiness. In fact, studies suggest happiness has a protective effect on the heart.

In a 10-year study released in 2010, emotions such as joy, happiness, excitement, enthusiasm and contentment were associated with better heart outcomes. In fact, the happier an individual was, researchers found, the less likely they were to develop heart disease. The study was the first of its kind.

What causes this protective effect? They study’s lead researcher suggested that happier people may enjoy longer periods of relaxation, a positive benefit for heart health. They also may have recovered more easily from stress and did not spend time reliving stressful events.

Other studies have found similar effects: Positive emotions in the elderly, for example, lower blood pressure and improve outcomes; optimism in women is associated with a 38 percent lower risk of death from heart disease and 39 percent lower risk of stroke-related death; and people who said they had a sense of purpose in their life had a lower risk for heart attack and stroke by 17 percent over those who felt no sense of purpose.

A 2018 study published in the Journal of the American College of Cardiology that summarized the research into positive thinking and cardiovascular disease, researchers theorized:

• Happiness may directly and positively impact the way our body works;
• Optimism is probably linked to healthy behaviors like eating right and exercising;
• Positive thinking may encourage social interaction, which in turn may offer our heart additional protection.

Lowering Your Risk of Heart Disease
If you have depression, how can you lower your risk of heart disease? Talk to your primary care doctor about your condition and ask about therapies that can improve depression. He or she may recommend seeing a therapist, taking medication or making lifestyle changes.

Don’t have a primary care doctor? MDVIP-affiliated physicians have time to really work with you and develop a wellness plan that can help you control your risk for heart disease. Find a physician near you and begin your partnership in health »