2023-04-19 01:21:31
When mental health improves, the risk of cardiovascular diseases is reduced. According to a study published in the “European Heart Journal”, if the treatment for depression is effective, there is a lower probability of suffering from heart disease and stroke.
“Our study suggests that improving mental health may also help physical health, especially in people under the age of 60,” says study author, Celine El Baoufrom University College London (UK). “People whose depression symptoms improved after therapy had a 10% to 15% lower risk of cardiovascular disease than those who did not. Comparable effects were found in similar studies investigating low-fat diets.”
Cardiovascular disease is the leading cause of death worldwide. About 523 million people were living with cardiovascular conditions in 2019. The risk of cardiovascular disease is approximately 72% higher among people with major depressive disorders compared to their healthy peers.
This is the first study to investigate whether reducing depression symptoms with psychological therapy is associated with a lower likelihood of future cardiovascular disease.
This is the first study to investigate whether reduction of depression symptoms with psychological therapy is associated with a lower likelihood of future cardiovascular disease.
In the work they participated 636,955 adults older than 45 years with depression who had completed a course of psychological therapy and were free of cardiovascular disease and dementia. The mean age was 55 years and 66% were women.
Information on psychological treatment, cardiovascular disease incidence and death was obtained from England’s national electronic health record databases and linked to the individual level.
The level of depression was assessed before and after therapy using the Patient Health Questionnaire-9 (PHQ-9), which gives a score from 0 (none) to 3 (almost every day) for nine items that include little interest or pleasure in doing things; feeling down, depressed, or hopeless; trouble falling asleep or staying asleep, or sleeping too much; feeling tired or low on energy; having a poor appetite or overeating; feeling that he is a failure or that he has let himself or his family down; difficulty concentrating on things; move or speak slowly or be fidgety or restless; thoughts that he would be better off dead or hurting himself in some way. Depression was defined as a score of 10 or more.
Improvement in depression was defined as a 6-point or greater reduction in the PHQ-9 score and no worsening of anxiety (defined as a 4-point or greater increase on the Generalized Anxiety Disorder scale) between baseline and the end of treatment. Anxiety was included in the definition so that the outcome of therapy would not be considered good if depression improved but anxiety worsened.
Patients were followed up for new onset of all-cause cardiovascular disease, coronary heart disease, stroke, and all-cause mortality. Follow-up began 365 days after the last therapy session, and patients with a cardiovascular event during this period were excluded to reduce the likelihood that a previously undiagnosed condition was the cause of depression.
During a median follow-up of 3.1 years, depression symptoms improved in 373,623 (59%) participants and did not in 263,332 (41%). There were 49,803 cardiovascular events and 14,125 participants died. Improvement in depression was associated with 12%, 11%, 12%, and 19% lower risk of any cardiovascular disease, coronary heart disease, stroke, and all-cause mortality, respectively, compared with no improvement. Analyzes were adjusted for characteristics that could influence relationships, such as age, ethnicity, gender, socioeconomic deprivation, and other health issues.
According to El Baou, “The results are consistent with previous research suggesting that interventions to modify risk factors for cardiovascular disease are more effective at a younger age. This highlights the value of receiving help soon to get the maximum benefit.
The authors acknowledge that the results do not definitively prove that the reduction in cardiovascular disease was due to alleviation of depression. In addition, data were lacking on lifestyle-related behaviours, such as smoking and inactivity, which could increase susceptibility to cardiovascular disease and limit the effect of psychological treatment.
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