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May 04, 2015

Depression Takes a Greater Toll on African-Americans with Heart Failure

Research findings warn against ignoring depressive symptoms in this population already at greater risk for the condition.

Although many studies have found that depression takes a toll on heart health, few studies have focused on heart failure outcomes in African-American patients, specifically. Published in the journal Circulation, a recent study analyzed the impact of depression on outcomes in African-Americans with the condition.

A total of 2,331 patients were included in the study, one-third of whom were African-American. All participants completed a 21-question examination upon enrollment, which assessed symptoms of depression, such as hopelessness and irritability. Subjects were then assigned a score ranging from 0 to 63, based on their responses to questions. Patients with a score of 14 or greater are considered to have clinical symptoms of depression; the higher the score, the more severe the depression.

After following patients for three months, researchers found that depression had a stronger negative impact on outcomes in African-Americans than whites. African-American patients with a score of 15 had 44% greater risk of hospitalization and death than those with a score of 5. In comparison, this difference in score only increased risk of hospitalization and mortality by 8% in white patients, and the association was not considered statistically significant. Also, researchers found that worsening depressive symptoms over the study period further increased risk of hospitalization and death in African-Americans.

Based on these findings, authors encourage routine assessment of depressive symptoms in African-American patients. Although depression can worsen outcomes in all heart failure patients, depression has an especially strong impact on outcomes in African-American patients, who are already at greater risk of heart failure. If depression is ignored and symptoms worsen over time, it can be particularly dangerous for African-Americans with heart failure. Mental health plays an important role for heart health, especially when it comes to living with chronic conditions like heart failure, and addressing depression may help improve outcomes and quality of life.

Questions for You to Consider

  • What is depression?
  • Clinical depression is a mood disorder that causes feelings of sadness, loss and anger to interfere with one’s daily life. Although the cause for depression is generally unknown, depression is often treated with antidepressants and/or talk therapy with a professional.
  • What is heart failure?

  • Heart failure occurs when the heart is unable to pump enough blood to the rest of the body. Although there is no cure for heart failure, treatments such as ACE inhibitors and ARBs can help improve outcomes as well as quality of life.

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Statistics show that an estimated five million Americans have heart failure. People who smoke, have diabetes and high blood pressure are at risk. So are people like Richard. He had a family history of heart problems and high cholesterol, likely in part from his love of fast food.