Heart attack warning: Depression symptoms may signal you’re at risk of heart disease

This Morning: Dr Chris discusses rise in heart disease deaths

A heart attack occurs when an artery supplying your heart with blood and oxygen becomes blocked. Fatty substances of cholesterol called plaques are usually responsible for this blockage. This harmful process is known as coronary heart disease, a condition that falls under the umbrella of heart disease. A new study has linked symptoms of depression to an increased risk of heart disease and stroke – another life-threatening condition whereby the flow of blood to the brain is cut off.

The key finding of the studl, published in the journal JAMA, is that people who experience symptoms of depression are more likely to go on to develop heart disease or suffer a stroke than those who report good mental health.

To gather their findings, researchers at the University of Cambridge analysed the health records of over half a million people, with no prior history of heart and circulatory disease, who were enrolled to two different studies: UK Biobank (2006-2010) and the Emerging Risk Factor Collaboration (ERFC; 1960-2008).

Upon joining the studies, participants were given a score based on questionnaires assessing their mood and any symptoms of depression that they had experienced over the previous one to two weeks.

These scores were divided into five groups based on increasing severity of symptoms.

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10 years later, researchers have found that those in the highest scoring group, and with most severe symptoms of depression, were more likely to have since developed heart disease or to have had a stroke, compared to people with the lowest scores.

In the UK Biobank cohort of 401,219 participants, there were 21 cases of heart disease per 1000 people across 10 years in those with the highest scoring group vs 14 cases of heart disease per 1000 people in the lowest scoring group.

There were 15 strokes per 1000 people over 10 years in those in the highest scoring group and 10 strokes per 1000 people in those with the lowest scores.

This means an extra seven cases of heart disease and five strokes per 10,000 people would be expected in one year for those with higher symptoms of depression.

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Similar results were found in the ERFC cohort of 162,036 people from 21 different studies across Europe and North America.

Whats more, the higher risk for heart disease and stroke existed even after risk factors for heart and circulatory diseases, such as age, sex, smoking status, history of diabetes, blood pressure, body mass index, and cholesterol levels, were accounted for.

The researchers point out that symptoms of depression were only measured when each individual joined the study.

This means the scores don’t necessarily reflect a person’s feelings across the entire time they were part of the study.

Professor Emanuele Di Angelantonio, BHF-funded researcher at the University of Cambridge, said:

“This is the largest evidence to date that feelings related to depression are associated with a person’s chance of having heart disease or stroke in the future.

“The observed higher risk is small in magnitude and these results are just one piece of the puzzle. We now need to do more research to understand whether these observed associations are causal and the possible biology behind this link.”

Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said:

“Our mental and physical health go hand-in-hand. It’s clear from this research that our hearts and minds are more connected than we previously thought. By exploring this link further, we may find new ways of helping to improve our heart health.

“However, it is important to stress that the increased risk is modest and observed over a long period of time. It should not alarm those currently experiencing low mood or feelings of depression about their immediate heart health.”

What are the main symptoms of a heart attack?

Symptoms of a heart attack can include:

• Chest pain – a sensation of pressure, tightness or squeezing in the centre of your chest
• Pain in other parts of the body – it can feel as if the pain is travelling from your chest to your arms (usually the left arm is affected, but it can affect both arms), jaw, neck, back and tummy (abdomen)
• Feeling lightheaded or dizzy
• Sweating
• Shortness of breath
• Feeling sick (nausea) or being sick (vomiting)
• An overwhelming sense of anxiety (similar to having a panic attack)
• Coughing or wheezing.

“Although the chest pain is often severe, some people may only experience minor pain, similar to indigestion,” explains the NHS.

In some cases, there may not be any chest pain at all, especially in women, older people, and people who have diabetes, the health body adds.

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