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Younger Women Prone to Depression After Heart Attack

Younger Women Prone to Depression After Heart Attack

40% struggle with the condition, which can hamper recovery, study says

By Steven Reinberg
HealthDay Reporter

TUESDAY, April 25 (HealthDay News) — While an episode of depression after a heart attack is fairly common, new research shows that women aged 60 and younger are far more likely to suffer from it than others.

The finding is important because people who struggle with depression after a heart attack are more likely to be hospitalized and die from cardiac problems, and have higher health-care costs, compared with heart-attack patients who don’t become depressed. Identifying depressed heart patients might help doctors better treat them, the researchers said.

“Depression is common among patients with heart attacks,” said study author Dr. Susmita Mallik, an assistant professor of medicine at Emory University School of Medicine. “About 22 percent of all heart-attack patients are depressed.”

However, younger women are more likely to be depressed than older patients, Mallik said. “Younger women were at the highest risk of depression. The prevalence of depression was 40 percent in women 60 years and younger,” she said.

The findings appear in the April 24 issue of the Archives of Internal Medicine.

For the study, Mallik and her colleagues looked at depression in 2,498 men and women who had suffered a heart attack between January 2003 and June 2004.

“We found that the prevalence of depression was 40 percent in women age 60 years or younger, 21 percent in women older than 60, 22 percent in men 60 or younger and 15 percent in men older than 60,” Mallik said.

What’s more, when the researchers looked at other factors, including race, medical history and coronary heart disease risk, the odds of depression were 3.1 times higher for women age 60 and younger than for men older than 60.

It’s not clear why younger women are at such a high risk for depression after a heart attack, Mallik said.

“Not all patients become depressed after having a heart attack,” Mallik said. “Depression should not be considered a normal reaction after a heart attack. Clinicians and patients should be aware that depression is an important risk factor for adverse outcomes after a heart attack.”

Mallik believes doctors should be looking for depression among heart attack patients, particularly younger women. “They should be aware that younger women are at the highest risk for depression, and screening for depression should be particularly aggressive in these women,” she said.

Dr. Nieca Goldberg, chief of women’s cardiac care at Lenox Hill Hospital in New York City, thinks women need to be more open with their doctor about their emotions after a heart attack.

“This paper is important, because it underscores the importance of evaluating the psychological issues that often accompany a heart attack,” she said.

Goldberg thinks younger women are more susceptible to depression because a heart attack is such a major event, especially at a younger age. “It’s a life-changing, stressful event,” she said. “It’s a shocking experience. There are concerns among women whether they are going to be able to get back and take care of their families and return to their usual life.”

Goldberg also noted the well-documented connection between the mind and the heart. “Clearly, depression does influence recurrent heart disease and is related to someone’s social support,” she said.

It’s important for women to have a good support network after suffering a heart attack, Goldberg said. “Women need to be able to share their emotional feelings after a heart attack,” she said. “Doctors have to be more careful to pick up depression.”

More information

The American Academy of Family Physicians can tell you more about depression after a heart attack (familydoctor.org ).

SOURCES: Susmita Mallik, M.D., M.P.H., assistant professor, medicine, Emory University School of Medicine, Atlanta; Nieca Goldberg, M.D., chief, women’s cardiac care, Lenox Hill Hospital, New York City; April 24, 2006, Archives of Internal Medicine

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