“…1 A meta-analysis found that the rates of mortality and cardiovascular events were twice as high in patients with HF and associated depression, 2 and this was often independent of functional class. 1,3 Some behavioral patterns contribute to these results, since patients with depression or anxiety often do not adhere to pharmacological treatment, are less active, have poor eating habits, and use tobacco. 1,3 However, the mutual association between depression, anxiety, and HF is more complex than it seems, involving similar pathophysiological bases that give rise to a vicious cycle, 1,4 as shown in Figure 1.…”