Depression Hard on Hearts 
                  En español 

People often laugh when they hear talk about the mind-body connection, but when it comes to cardiac health, everyone – especially women – must take that connection seriously.

Dozens of studies over many decades have shown a strong link between depression and an increased risk of cardiovascular disease. So much so that the American Heart Association is now advising all doctors to screen for depression when assessing a patient's overall cardiac risk.

Why does depression especially matter for women?

• Women are twice as likely as men to have depression in the first place.
• Further, once a woman has a heart attack, the general consensus is that having depression doubles her risk of another in the first year or two of recovery. This is more than twice the risk faced by men.
• Finally, all patients with depression often have additional risk factors for the development of coronary artery disease.

This does not surprise me. Like many of my colleagues, I have believed for some time that the link between depression and increased cardiovascular risk is real and significant.

Depression absolutely must be treated – especially in women. Women suffer depression twice as much as men, and their cardiovascular outcomes are twice as bad when they are depressed.

For women, I suspect that by treating depression, we can reduce the overall risk of heart disease by as much as 20 percent. That is huge – it is as much of a risk reduction as taking an aspirin a day has been for people at high risk of heart attack or stroke.

I've said it before, and it bears repeating:  

• Heart disease, including stroke, is a woman's disease.
• Heart disease is the No. 1 killer of women.

Identifying and managing depression plays a very real role in reducing your risk of becoming a cardiovascular statistic.

Anytime you feel down for more than a week, tell your doctor. While some doctors may think depression is "normal" after a cardiac event, mounting evidence suggests depression already exists in many cardiac patients. There are a number of effective ways to treat depression including anti-depressant drugs, behavioral therapy and physical activity.

You don't have to suffer. Your doctor can help. 

Do it for yourself. Do it for your family and friends. Do it for your quality of life. 

Until next time!

Stephanie Coulter, MD  

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