The Relation between Depression and Ischemic Heart Disease among Middle Aged People: a Case Control Study

Document Type : Research Paper

Authors

1 Medical Students research committee, Shahed University, Tehran, Iran

2 Department of Cardiology, Faculty of Medicine, Shahed University, Tehran, Iran.

3 Medical Students Research Committee, Shahed University, Tehran, Iran.

4 Medical Students Scientific Association, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.

5 Social Medicine Department, Shahed University, Tehran, Iran

6 Social Medicine Department, Shahed University, Tehran, Iran.

Abstract

Background and Objective: Depression is one of the most common psychological problems, which can elevate the risks of cardiovascular complications. This study was performed with the aim of retrospectively reviewing the relationship between these two illnesses in middle-aged people.
Materials and Methods: In this case control study, 200 patients were randomly chosen as the case group from among patients whose diagnosis of ischemic heart disease (IHD) was confirmed by angiography, women younger than 55 and men younger than 45, and another 200 patients without IHD were chosen as control subjects. In order to assess the patients’ depression, Beck’s Depression Questionnaire was used in both groups. Data was analyzed using SPSS v.16 software  .
Results: Results of the Beck’s Questionnaire taken from both groups showed a mean score of 13.9±8.48 in the case group and 10±5.93 in the control group (p<0.001). Moreover, the difference between the two groups pertaining to the severity of depression was also found to be statistically significant (p<0.001). Also, more women were found to be clinically depressed compared to men (p<0.001).
Conclusion: Depression is considered an independent risk factor for the development of IHD, moreover, based on the previous studies conducted, risk of developing IHD are higher among those already affected by depression and in middle-aged people which needs further analyses and studies to be conducted in order to better understand this relationship and to better develop treatment strategies.

Keywords


  1. Dostkamy H, Hosseinian J, Fatehi GH. The prevalence of myocardial infarction without ST segment in patients with primary diagnosis of unstable angina in the Ardabil Bouali hospital. Journal of Ardabil University of Medical Sciences 2006; 6(1): 37-43.
  2. Boden WE, O'Rourke RA, Crawford MH, Blaustein AS, Deedwania PC, Zoble RG, et al. Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy. Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQWISH) Trial Investigators. The New England Journal of Medicine 1998; 338:(25):1785-92.
  3. Crea F, Battipaglia I, Andreotti F. Sex differences in mechanisms, presentation and management of ischaemic heart disease. Atherosclerosis 2015;241(1):157-68.
  4. Mack M, Gopal A. Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease. Heart Failure Clinics 2016;12(1):1-10.
  5. Nasrabadi T, Goodarzi Zadeh N, Shahrjerdi A, Hamta A. The Effect of Education on Life Style Among Patients Suffering from Ischemic Heart Disease. Journal of Mazandaran University of Medical Sciences 2010; 20 (79) :72-79.
  6. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;386(9995):743-800.
  7. Ghosian Moghadam MH, Ansari I, Roghani M, Ghanem A, Mehdizade N. The Effect of Oral Administration of Hypericum Perforatum on Serum Glucose and Lipids, Hepatic Enzymes and Lipid Peroxidation in Streptozotocin-Induced Diabetic Rats. Galen Medical Journal 2017;6(4):319-329.
  8. Najafipour H, Banivaheb G, Sabahi A, Naderi N, Nasirian M, Mirzazadeh A. Prevalence of anxiety and depression symptoms and their relationship with other coronary artery disease risk factors: A population-based study on 5900 residents in Southeast Iran. Asian Journal of Psychiatry 2016;20:55-60.
  9. Ghaleiha A, Emami F, Naghsh Tabrizi B, Ali Hassani, R. A Survey on the Frequency of Depression and Anxiety in the Patients with Acute Coronary Syndrome, Ekbatan Hospital of Hamadan City. Avicenna Journal of Clinical Medicine 2011; 17 (4) :43-49.
  10. Serrano CV Jr, Setani KT, Sakamoto E, Andrei AM, Fraguas R. Association between depression and development of coronary artery disease: pathophysiologic and diagnostic implications. Vascular Health and Risk Management 2011;7:159-64.
  11. Sobel RM, Markov D. The impact of anxiety and mood disorders on physical disease: the worried not-so-well. Current Psychiatry Report 2005;7 (3): 206-12
  12. Saran RK, Puri A, Agarwal M. Depression and the heart. Indian Heart Journal 2012;64(4):397-401.
  13. Tajfard M, Ghayour Mobarhan M, Rahimi HR, Mouhebati M, Esmaeily H, Ferns GA, et al. Anxiety, depression, coronary artery disease and diabetes mellitus; an association study in ghaem hospital, iran. Iran Red Crescent Medical Journal 2014;16(9):e14589.
  14. Parashar S, Rumsfeld JS, Spertus JA, Reid KJ, Wenger NK, Krumholz HM, et al. Time course of depression and outcome of myocardial infarction. Archives of Internal Medicine 2006; 166(18): 2035-43.
  15. Moradyan ST, Ebadi A, Saeid Y, Asiabi M. Hospital anxiety and depression in patients with coronary artery disease. Iranian Journal of Psychiatric Nursing 2013;1(2):54-61.
  16. Dempe C, Junger J, Hoppe S, Katzenberger ML, Moltner A, Ladwig KH, et al. Association of anxious and depressive symptoms with medication nonadherence in patients with stable coronary artery disease. Journal of Psychosomatic Research 2013; 74(2): 122-7.
  17. Hoen PW, Whooley MA, Martens EJ, Na B, van Melle JP, de Jonge P. Differential associations between specific depressive symptoms and cardiovascular prognosis in patients with stable coronary heart disease. Journal of the American College of Cardiology 2010; 56(11): 838-44.
  18. Rosenbloom JI, Wellenius GA, Mukamal KJ, Mittleman MA. Self-reported anxiety and the risk of clinical events and atherosclerotic progression among patients with Coronary Artery Bypass Grafts (CABG). American Heart Journal 2009; 158(5): 867-73.
  19. Frasure-Smith N, Lesperance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Archives of General Psychiatry 2008; 65(1): 62-71.
  20. Huang CJ, Hsieh MH, Hou WH, Liu JC, Jeng C, Tsai PS. Depression, antidepressants, and the risk of coronary heart disease: a population-based cohort study. International Journal of Cardiology 2013;168(5):4711-6.
  21. Gravely-Witte S, Stewart DE, Suskin N, Grace SL. The association among depressive symptoms, smoking status and antidepressant use in cardiac outpatients. Journal of Behavioral Medicine 2009;32(5):478-90.
  22. Bounhoure JP, Galinier M, Curnier D, Bousquet M, Bes A. Influence of depression on the prognosis of cardiovascular diseases. Bulletin de L'Académie Nationale de Médecine 2006; 190(8): 1723-31.
  23. Follath F. Depression, stress and coronary heart disease--epidemiology, prognosis and therapeutic sequelae. Therapeutische Umschau 2003;60(11):697-701.
  24. Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. Journal of the American College of Cardiology 2005; 45(5):637–651.
  25. Abbasi SH, Kassaian SE, Sadeghian S, Karimi A, Saadat S, Peyvandi F, et al. Introducing the Tehran Heart Center's Premature Coronary Atherosclerosis Cohort: THC-PAC Study. The Journal of Tehran Heart Center 2015;10(1):34-42.
  26. Majed B, Arveiler D, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, et al. Depressive symptoms, a time-dependent risk factor for coronary heart disease and stroke in middle-aged men: the PRIME Study. Stroke 2012;43(7):1761-7.
  27. Shah AJ, Ghasemzadeh N, Zaragoza-Macias E, Patel R, Eapen DJ, Neeland IJ, et al. Sex and age differences in the association of depression with obstructive coronary artery disease and adverse cardiovascular events. Journal of the American Heart Association 2014;3(3):e000741.
  28. Piwoński J, Piwońska A, Sygnowska E. Is there an association between depressive symptoms and coronary artery disease in the Polish adult population? Kardiologia Polska 2014;72(1):50-5.
  29. Vural M, Satiroglu O, Akbas B, Goksel I, Karabay O. Coronary artery disease in association with depression or anxiety among patients undergoing angiography to investigate chest pain. Texas Heart Institute Journal 2009;36(1):17-23.
  30. Ozturk S, Yalvac HD, Sivri N, Ozturk HM, Kılıc Y, Bulut E, et al. Anxiety and depression scores in patients with coronary artery disease and coronary artery ectasia. International Journal of Cardiology 2015;186:299-301.
  31. Cho KI, Shim WJ, Park SM, Kim MA, Kim HL, Son JW, et al. Association of depression with coronary artery disease and QTc interval prolongation in women with chest pain: data from the KoRean wOmen'S chest pain rEgistry (KoROSE) study. Physiology and Behavior 2015;143:45-50.
  32. Park JH, Bae SH. A systematic review of psychological distress as a risk factor for recurrent cardiac events in patients with coronary artery disease. Journal of Korean Academy of Nursing 2011;41(5):704-14.
  33. Rutledge T, Reis SE, Olson M, Owens J, Kelsey SF, Pepine CJ, et al. Depression is associated with cardiac symptoms, mortality risk, and hospitalization among women with suspected coronary disease: the NHLBI-sponsored WISE study. Psychosomatic Medicine 2006;68(2):217-23.