Depression and Risk of Heart Failure Among the Elderly: A Prospective Community-Based Study

Williams, Setareh A.; Kasl, Stanislav V.; Heiat, Asefeh; Abramson, Jerome L.; Krumholz, Harlan M.; Vaccarino, Viola

doi:10.1097/00006842-200201000-00002

Cited by 187 publications

(136 citation statements)

References 35 publications

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“…Mental stress and depression also precipitate worsening of established HF. 42,103,104 Systemic biomarkers may indicate the risk of development of HF. Microalbuminuria, defined as an albumin/creatinine ratio of 2 mg/mmol, is associated with a 3-fold increase in the risk of hospitalization for HF, and every 0.4-mg/mmol increase in the albumin/creatinine ratio is associated with a Ͼ10% increase in worsening of HF.…”

Section: Minor Clinical Risk Factorsmentioning

confidence: 99%

Prevention of Heart Failure

et al. 2008

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Abstract-The increase in heart failure (HF) rates throughout the developed and developing regions of the world poses enormous challenges for caregivers, researchers, and policymakers. Therefore, prevention of this global scourge deserves high priority. Identifying and preventing the well-recognized illnesses that lead to HF, including hypertension and coronary heart disease, should be paramount among the approaches to prevent HF. Aggressive implementation of evidence-based management of risk factors for coronary heart disease should be at the core of HF prevention strategies.Questions currently in need of attention include how to identify and treat patients with asymptomatic left ventricular systolic dysfunction (Stage B HF) and how to prevent its development. The relationship of chronic kidney disease to HF and control of chronic kidney disease in prevention of HF need further investigation. Currently, we have limited understanding of the pathophysiological basis of HF in patients with preserved left ventricular systolic function and management techniques to prevent it. New developments in the field of biomarker identification have opened possibilities for the early detection of individuals at risk for developing HF (Stage A HF). Patient groups meriting special interest include the elderly, women, and ethnic/racial minorities. Future research ought to focus on obtaining a much better knowledge of genetics and HF, especially both genetic risk factors for development of HF and genetic markers as tools to guide prevention. Lastly, a national awareness campaign should be created and implemented to increase public awareness of HF and the importance of its prevention. Heightened public awareness will provide a platform for advocacy to create national research programs and healthcare policies dedicated to the prevention of HF. (Circulation. 2008;117:2544-2565.) Key Words: AHA Scientific Statements Ⅲ heart failure Ⅲ prevention Ⅲ left ventricular dysfunction Ⅲ genetics Ⅲ awareness T he prevention of heart failure (HF) is an urgent public health need with national and global implications. According to the American Heart Association, an estimated 550 000 new cases occur each year. 1 More than 5 million Americans have HF. Among Medicare beneficiaries, HF is the leading cause of hospitalization. In 2007, the American Heart Association estimates that Ͼ$33 billion was spent on HF. 1 The syndrome of HF poses many challenges. Because of the complexity of its many causes and pathophysiological origins, HF may escape a unifying definition. From many The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the Ame...

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Section: Minor Clinical Risk Factorsmentioning

confidence: 99%

Prevention of Heart Failure

et al. 2008

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“…However, in a multivariable model, psychosocial factors were stronger risk factors for incident MI than diabetes, smoking, hypertension, and obesity. 10 Depression has also been associated with the development of congestive heart failure (CHF) 11,12 and with adverse outcomes in patients with CHF. [13][14][15] In a study examining incidence of CHF among 4500 patients who were enrolled in the Systolic Hypertension in the Elderly Program, the cumulative incidence of CHF in the depressed patients was 16%, whereas the incidence was only 7% in the nondepressed group.…”

Section: Did Depression Increase This Patient's Risk For a Recurrent mentioning

confidence: 99%

Depression and Cardiovascular Disease

Whooley¹

2006

JAMA

218

163

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Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. CASE PRESENTATIONA 58-year-old man with a history of coronary heart disease (CHD), type 2 diabetes mellitus, hypertension, smoking, and alcohol dependence presented for routine medical care. He had initially sought medical attention for exertional angina 5 years previously, at which time he underwent exercise treadmill testing with thallium that was positive for reversible perfusion defects in the anterior, septal, and inferior walls. Subsequent coronary angiography revealed diffuse heavy calcifications in the left anterior descending artery with a moderate lesion prior to the first diagonal. Several major septal perforators had significant lesions at their origins. In the dominant right coronary artery, there were diffuse calcifications but no significant lesions. The left circumflex and large ramus intermedius were free of discrete lesions. Left ventricular function was normal.The patient underwent single-vessel (left internal mammary artery to left anterior descending artery) coronary artery bypass grafting (CABG) surgery. He was prescribed atenolol 100 mg/ d, lisinopril 40 mg/d, lovastatin 80 mg/d, aspirin 325 mg/d, metformin 850 mg 3 times a day, and glipizide 10 mg 2 times a day. Despite being nonadherent to his prescribed medications, he remained stable for 5 years, but then one day, while doing household chores, he suddenly developed chest pressure, shortness of breath, and diaphoresis that lasted 12 hours. On admission to the hospital his troponin I was elevated and peaked at 0.7 ng/mL (normal, <0.05 ng/mL), consistent with a myocardial infarction (MI). His electrocardiogram had not changed.

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“…3 Our findings were consistent with those of previous investigations in which depression was shown to have a greater effect on poor cardiovascular outcomes in women than in men. 7,8 This suggested a greater vulnerability of women not only toward depression, which is well established, 9 but also toward the adverse effects of depression on open heart surgery.…”

Section: Discussionmentioning

confidence: 96%