Anxiety, depression may worsen your heart health

Symptoms of depression and anxiety are present in about one-third of patients with heart failure and these patients are at a higher risk of progressive heart diseases and other adverse outcomes, a new study suggests.

The study, published in the journal Harvard Review of Psychiatry, found evidence confirming "markedly higher" rates of depression and anxiety disorders among patients with heart failure, compared to the general population.

Heart failure is a chronic, progressive condition in which the heart can't pump enough blood, causing symptoms such as fatigue and shortness of breath.

"Depression has been linked to the development and progression of heart failure and other cardiovascular diseases," said co-author Christopher Celano from Harvard University' s Medical School.

The researchers said that previous studies have linked psychiatric disorders to worse outcomes in patients with heart failure. 

To clarify these relationships, the researchers did a targeted review of research on associations between heart failure, depression, and anxiety.

The researchers found that anxiety is highly frequent among patients with heart failure and both physiological and behavioural factors may contribute to adverse outcomes.

Nearly 30 per cent of patients have clinically significant anxiety symptoms, while 13 per cent meet diagnostic criteria for anxiety disorders (such as generalized anxiety disorder, post traumatic stress disorder or panic disorder). 

Depression and anxiety may make it more difficult for patients with heart failure to follow recommendations for diet, exercise and medication use. Earlier studies have also linked depression to metabolic changes, including increased levels of inflammatory markers, the researchers added.

The researchers noted that formal diagnostic interviews (i.e. based on DSM-5 criteria) can help in assessing the cause of overlapping symptoms between heart failure and depression or anxiety including problems with sleep, concentration, or energy.