Don't Go Breaking My Heart

Anxiety and depression in heart disease patients linked to increased risk of death

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Individuals with heart disease are already at a higher risk of death from their heart condition. But adding depression or anxiety – or both – to the mix can raise the stakes.

A recent study found that both depression and anxiety were linked to an increased risk of death among patients with heart disease.

If patients had one or the other, they had almost twice the risk of dying within the following three years.

If they had both, they had three times the risk.

"Seek help for anxiety and depression."

The study, led by Lana Watkins, PhD, an associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center, focused on the impact of anxiety and depression on patients with heart disease.

The researchers studied 934 men and women who had cardiovascular disease. The participants completed an assessment that measured their levels of depression and anxiety while they were in the hospital for coronary angiography. Coronary angiography is a test that allows doctors to see inside patients' arteries.

The researchers tracked these adults over the next three years, and 133 of them died. Then the researchers compared the rates of death between those with higher scores and those with lower scores on the anxiety and depression assessment.

The researchers found that individuals scoring on the high end of the anxiety section of the assessment had more than twice the risk of dying than those without higher anxiety scores.

The higher risk of death among those with anxiety existed even when the researchers took into account other risk factors.

Those other factors included patient's age, congestive heart failure, a measurement of the blood being pumped out of patients' left ventricle, renal disease and three-vessel disease.

When the researchers focused on the depression section of the assessments, they found that individuals were also at twice the risk of dying if they scored high on that section.

These risk calculations related to a person's anxiety or depression did not take into account whether individuals had one or both mental health conditions.

Therefore, the researchers calculated the extent to which each mental health condition may be related to the risk of death on its own, since individuals might have scored high on both sections.

The researchers found that both conditions were still individually linked to higher risks of deaths, but the risk increase was not as high as it was for individuals who had both anxiety and depression.

Those with anxiety had an 83 percent higher risk of death than those without anxiety, after accounting for the existence of depression in the same patients. (This means they calculated how much anxiety appeared linked to the risk of death if the effects of depression were not relevant.)

Those with depression were at a 66 percent higher risk of death than those without depression, after accounting for anxiety.

Then the researchers looked specifically at the patients who had both anxiety and depression symptoms. They found these patients to be at three times the risk of death than those without anxiety or depression.

The researchers concluded that patients with heart disease are therefore at a higher risk of death if they have anxiety, especially if they also have depression.

The study was published March 19 in the Journal of the American Heart Association. The research was funded by the National Institutes of Health. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
March 19, 2013
Last Updated:
March 23, 2013