It has long been known that depression increases the risk of heart disease by as much as 50%. A new study of veterans in San Francisco indicates that the reason for this may be surprisingly simple. Depressed people rarely exercise, and lack of exercise is well-known contributor to heart ailments.
Doctors at the Veterans Affairs Medical Center in San Francisco tracked the behaviors of 1,017 patients with heart disease, and about 10% of depressed heart patients had additional heart problems, compared with only 6.7% of other patients. That relatively small difference became a 31% higher risk of heart problems among the depressed people once confounding variables were removed. However, once the variable of exercise was removed, the difference vanished. Patients who didn’t exercise had a 44% higher risk of heart problems, whether or not they were depressed.
Previous studies have pointed to a possible link between antidepressant use and lower heart risk. Dr. Mary A. Whooley, professor of medicine, epidemiology, and biostatistics at the University of California, San Francisco, was one of the researchers. Whooley believes the study provides convincing evidence that lifestyle factors are the main factor in depression’s link to heart disease, at least in populations demographically similar to the men in the study—older men with stable coronary disease.
Identifying this connection doesn’t mean these findings translate easily into lowered mortality rates. “The clinical practice question is a challenging one,” says Dr. Whooley. “It’s easy for us to tell patients to exercise, take their medicines, and refrain from smoking, but actually changing health behaviors is very difficult.”
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