For individuals with moderate to severe depression, antidepressants may be more effective than cholesterol-lowering medication in reducing risk for heart disease, according to a study to be presented at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.
Depression is a known risk factor for heart disease, the No. 1 killer of men and women in the United States. Patients with depression have two to four times greater risk of developing heart disease than those without it. Research suggests depression is very common, impacting 1 in 10 Americans. The question is: Can antidepressants reduce risk for heart disease?
So far, studies assessing the impact of antidepressants on cardiovascular risk have had mixed results. To learn more, researchers from the Intermountain Medical Center Heart Institute in Salt Lake City analyzed the health records of more than 26,000 patients treated in the statewide network of health centers over a three-year period. Based on a screening questionnaire, which assessed factors like mood, sleep and appetite, researchers identified 5,311 patients as having moderate to severe depression.
After comparing patients with moderate to severe depression, investigators found that those taking antidepressants alone had 53% lower risk of heart disease and death than those not taking medication. Surprisingly, taking cholesterol-lowering statins on top of antidepressants actually had no significant added benefits in this group. Among patients with moderate to severe depression, taking antidepressants also appeared to improve outcomes more than taking statins alone, although further research is needed to confirm this association.
Based on findings, identifying patients in need of treatment for depression is a must.
“What I take away from this study is that screening and treatment of depressive symptoms should be a high priority,” said Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute, Salt Lake City, and the study’s lead author. “Antidepressants were not associated with a reduced cardiovascular risk in people with little or no depression, but in moderately to severely depressed people, antidepressants were shown to significantly improve cardiovascular outcomes.”
“Antidepressants might have relevant physiological benefits, but I also think that improving a person’s mood can contribute to a cascade of behavioral changes that improve cardiovascular health,” May said. “For example, people who are having depressive symptoms may not be as inclined to exercise, practice good health habits or comply with health advice. Using an antidepressant to reduce depressive symptoms might also help people better take care of their heart health.”