WOMEN MORE LIKELY TO DEVELOP ANXIETY AND DEPRESSION AFTER HEART ATTACK
Women are more likely
to develop anxiety and depression after a heart attack (myocardial infarction;
MI) than men, according to research presented at Acute Cardiovascular Care 2014
by Professor Pranas Serpytis from Lithuania.
Professor Serpytis
said: "The World Health Organization predicts that by 2020 depression will
be the second leading cause of disability and mortality in the world, surpassed
only by ischaemic heart disease. Major depression follows MI in approximately
18% of cases and is an important predictor of disability and poor quality of
life in the year post-MI."
He continued:
"Patients with depression are nearly 6 times more likely to die within 6
months after an MI than those without depression. The increased risk of death
in patients with depression persists up to 18 months after the MI. But despite
the fact that post-MI depression is common and burdensome, the condition
remains under-recognised and undertreated."
The current study
investigated the impact of gender and cardiovascular disease risk factors on
the risk of developing depression and anxiety after an MI.
The study included 160
patients admitted with a myocardial infarction to the Vilnius University
Hospital Santariskiu Clinics in Vilnius, Lithuania. Patients were interviewed
at least 1 month after the MI to collect information on demographic (including
sex, age, education, marital status) and clinical characteristics (incidence of
diabetes mellitus, previous treatment for hypertension, previous MI), other cardiovascular
disease risk factors (smoking, physical activity), and history of mental health
issues.
Depression and anxiety
were both assessed using the Hospital Anxiety and Depression Scale (HADS): no
depression and anxiety (0-7 score), possible depression and anxiety (8-10
score), mild to moderate levels of depression and anxiety symptoms (11+ score).
The researchers found
that nearly one quarter of patients in the study were depressed (24.4%) and of
those, 28.2% had received treatment with antidepressants (p<0.05). The
average HADS score for depression was 6.87 (±4.6) in men and 8.66 (± 3.7) in
women (p<0.05). For anxiety the mean score was 7.18 (±4.6) in men and 8.20
(±3.9) in women (p<0.05).
Professor Serpytis
said: "We found that women were more likely to develop anxiety and
depression after a heart attack than men. More research is needed to discover
the possible reasons for this."
The researchers also
found an association between anxiety and smoking. In the study, 15.6% patients
were current smokers and their mean HADS score for anxiety was 10.16 (±4.9). An
additional 77.5% of patients had never smoked and their mean HADS score for
anxiety was 7.3 (±4.1), while the 6.9% patients who had quit smoking more than
2 years ago had a mean HADS score for anxiety of 4.55 (±3.7) (p<0.05).
Professor Serpytis
said: "Current smokers were more likely to have anxiety after an MI than
never smokers or people who had quit smoking more than two years ago. We did
not find any association between smoking and depression after an MI."
Physically inactive
patients tended to be depressed, with a mean HADS score of 8.96 (+4.1).
Overall, 64% of patients with depression said they were not physically active
(p<0.05).
Professor Serpytis
said: "Women are misrepresented in many clinical studies on MI even though
they often have worse outcomes. Our study shows that women are more likely to
develop anxiety and depression after MI than men but until now this issue has
been largely unnoticed. Clinicians should assess MI patients, particularly
women, for anxiety and depression so that timely treatment can be
started."
He concluded:
"Our study suggests that encouraging patients to quit smoking and increase
their physical activity levels should reduce their risks of anxiety and
depression after MI. More research is needed on the links between myocardial
infarction and mental health problems."
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