Women at higher cardiovascular risk were more likely to have symptoms of depression, study finds
For generations, people have been fascinated by the connections between mind and body. For example, do people really die of a broken heart? Does a healthy mind indicate a healthy body?
Scientists have been studying associations between mental and physical health for some time. One such association is between depression and heart disease. Research has shown that depression is more common in people with heart disease, compared to the general population.
Moreover, in the case of physically healthy people, when followed for many years, those with high levels of depressive symptoms are more likely to develop heart disease than those without depression.
We also know that in people with acute heart disease (for example, they have had a heart attack), depression is associated with an increased risk of new heart attacks and death, not only from heart disease, but whatever whatever the cause.
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However, fewer studies have investigated whether these trends exist in reverse, that is, whether cardiovascular risk factors are associated with a higher likelihood of developing depression. But now a new study published in the journal PLOS ONE sought to explore this.
What did the researchers do?
Sandra Martín-Peláez from the University of Granada in Spain and her colleagues focused on people with metabolic syndrome to explore the link between cardiovascular risk factors and depression in people aged 55 to 75.
Metabolic syndrome is a group of conditions that occur together including high blood pressure, high blood sugar, excess body fat around the waist, and high cholesterol that increase the risk of heart disease, stroke stroke and type 2 diabetes. Some researchers have suggested that metabolic syndrome may also play a role in depression.
The participants in this study came from a larger trial analyzing the effects of a Mediterranean diet on people who are overweight or obese and have metabolic syndrome. The ongoing randomized trial consists of one group following a low-calorie Mediterranean diet and an exercise program, and another group following an unrestricted Mediterranean diet without an exercise program.
Over 6,500 participants were included in the baseline analysis for the PLOS ONE study, with more than 4,500 followed two years later. The researchers used the well-established Framingham Risk Score, which was developed by following healthy people over time to determine major risk factors for heart disease. They classified people as having a low, medium or high risk of having a heart attack or dying from heart disease within ten years.
Participants were asked about their depressive symptoms using questionnaires at baseline (when they first started following the diets and physical activity programs) and then two years later.
Surprisingly, no significant association was found between cardiovascular risk and depression at baseline or at follow-up. So, overall, participants with a higher risk of heart disease were not more likely to suffer from or develop depression.
When the authors analyzed the data by gender, they found that, at baseline, women with higher cardiovascular risk were more likely to have symptoms of depression. But this was not the case in men, neither in men nor in women at follow-up.
On average, all participants’ depression scores declined at two years. Depression scores fell more for those with low cardiovascular risk and for those in the intervention group (participants who followed the restricted diet and physical activity program).
It is difficult to clearly interpret the results of this study. The data has been analyzed in several different ways, and the results are mixed. For example, the authors analyzed the data by different metabolic syndrome factors, finding that diabetes and certain cholesterol levels led to lower depression scores at follow-up.
But we know from other research that women with heart disease have higher levels of depression than men with heart disease. It is also well established that in the general population, women experience higher rates of depression than men. Thus, the finding that there may be a link between heart disease risk and depression in women seems to align with these trends.
Why are depression and heart disease linked?
Although we cannot conclude from this study that the risk of heart disease is associated with a higher risk of developing depression, it adds to an already strong body of evidence suggesting that heart disease and depression are linked.
Several factors, behavioral and biological, may explain this relationship. Some of the biological factors common to depression and heart disease risk include increased inflammation, endothelial dysfunction (constriction of blood vessels in the heart), impaired autonomic nervous system activity (the autonomic nervous system controls muscles , including the heart) and blood platelets. dysfunction (where blood platelets are more likely to stick together and form clots).
Additionally, we know that factors related to a healthy lifestyle, such as being physically active, not smoking, and maintaining a healthy diet, protect against heart disease and depression. The opposite is also true that unhealthy lifestyle factors are associated with an increased risk of heart disease and depression.
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Unfortunately, people with depression find it more difficult to change such habits, such as quitting smoking. So, probably the most interesting finding from this study is that depression scores were reduced in the group who were encouraged and supported to adopt a healthier lifestyle, including a more restrictive diet and increased physical activity. .
Although there is good evidence to suggest that exercise is a very effective treatment for depression in people with heart disease, the role of diet as an intervention for depression is less clear. This study provides a promising impetus for further investigation of diet and lifestyle as potential treatments for depression in people with or at risk of heart disease. (The conversation)