A Study to Assess the Prevalence of Depression in Cardiovascular Disease Patient in The Nilgiris Population: Association with Blood Pressure

Abstract

Depression is a common disorder in Cardio-vascular patients with a prevalence of twenty percent (20%) to forty five percent (45%), which is much more frequent than in the general population. Depressive symptoms are often overlooked in cardiac patients and their manifestation, especially after MI, is considered normal. Almost every life-threatening condition, including MI, stimulates the hypothalamus to secrete the corticotropic-releasing hormone, which stimulates the HPA axis. The two-way connection between depression and heart disease, which share the pathophysiological mechanism of origin, affects the prognosis of post-infarction recovery of depressed patients due to the impact of depression on the HPA axis activation, endothelial dysfunction, platelet reactivation and enhanced inflammatory response. An observational, cross-sectional study was conducted at secondary care government hospitals located at the Nilgiris district on different cardiovascular disease patients using HAM-D questionnaires for the assessment of depression. In this study, the level of depression in cardiovascular disease patients were assessed associating with patient variability in relation to age, gender, education, food habits, social habits, duration of disease and blood pressure values. There was a significant increase in depression score with the increase in blood pressure level. The patients were found to be having depression even though they were on cardiovascular treatment after they were being diagnosed with cardiovascular disease. With the treatment of cardiovascular disease conditions, the assessment for depression should be done and if required, depending on the level of depression, counselling and/with psychotherapy (eg. Cognitive behavioural therapy) may be recommended to avoid cardiac morbidity and mortality.