Why Heart Disease Patients Get Depressed, and vice versa

If I had coronary arterial disease, I guess I’d be depressed. But that’s an immediate reaction, whereas after a little thought, I’d probably be looking for the best treatment program. Which might include plenty of exercise.
It’s accepted that depression has long been associated with an increase in the risk of more serious heart disease, but there isn’t a clear explanation of the reason. Results from the Heart and Soul Study, reported in the Journal of the American Medical Association, give us more info on this.
Over 1,000 patients with stable coronary disease were enrolled in the San Francisco Bay area. Depressive symptoms were assessed at entry. They were then followed for up to 8 years.
Those participants with depressive symptoms had a 10% chance of having a cardiovascular event during the study period – heart failure, heart attack (MI), stroke, transient ischemic attack (TIA), or death. The rate in those without depressive symptoms was only 6.7% - i.e. roughly 1.5 times less frequent.
The investigators went on to analyze the findings after adjustments were made for physical activity/inactivity, and found that when this factor was included, there was no significant association between depression and a cardiovascular event. This shows, pretty conclusively, that the link between depression and serious cardiovascular events like heart attack was related to lack of physical activity. In other words, exercise to avoid a heart attack, even if you’re depressed!