Guidelines alert heart patients to depression risk

Heart patients should be screened routinely for depression, a common complication that can make a second heart attack more likely, according to guidelines released by the American Heart Association on Monday.

They reflect growing evidence that depression often follows a heart attack, and depressed heart patients are at higher risk for more heart trouble.

"Studies show that depression is about three times more common in patients following a heart attack than in the general community," said Judith Lichtman of Yale University School of Medicine, who helped write the new guidelines, which appear in the journal Circulation.

"Because there has been no routine screening for depression in heart patients, we think there is a large group of people who could benefit from appropriate treatment," she said in a statement.

Lichtman said more research is needed to understand why heart patients are more likely to be depressed.

For Barbara Forman of Dayton, Ohio, depression set in shortly after her double bypass surgery 5 years ago. "I had the idea that I would be an invalid for the rest of my life," she said in a telephone interview.

Forman believes the heart disease triggered her depression. She got help from medication, and now volunteers for Mended Hearts, a support group.

Getting help may save lives, Lichtman said. Studies show depressed heart patients are more likely than others to stop taking their heart medications and are less likely to stay on heart-healthy diets or get regular exercise.

Depression can also bring about changes in the body, including reduced heart rate and increases in blood factors that encourage the formation of blood clots.

The group recommends early and repeated screenings for depression. Heart patients showing signs of depression should be evaluated by a mental health professional and screened for other psychiatric disorders, such as anxiety.

Treatment options might include therapy, exercise, antidepressants, cardiac rehabilitation or a combination of these approaches.

By Julie Steenhuysen
CHICAGO (Reuters)