Date of Award

12-2024

Document Type

Dissertation

Degree Name

Doctor of Medical Science (DMSc)

First Advisor

Jason Brumitt

Abstract

Introduction

Depression and cardiovascular disease (CVD) are closely interrelated, with depressive symptoms significantly more common in patients with heart disease than in the general population. Several studies have shown that between one-fifth to one-third of patients with severe acute coronary disease exhibit depressive signs, while around 10% meet the standards for major depressive disorder. This heightened occurrence of depression among ACS patients correlates with unfavorable cardiovascular outcomes, an amplified probability of recurrent heart events, and escalating healthcare costs.1 Despite its acknowledged sway on cardiovascular health, depression often goes undiagnosed and untreated in this group. According to the World Health Organization, cardiovascular disease has been recognized as a primary reason for mortality in the United States from 2000 through 2019.2 Reviewing risk factors plays an important part in prevention and addressing the progression.

As an independent risk factor for coronary artery disease, depression exacerbates health results in both people who have pre-existing cardiac conditions and those who are generally healthy. Following a heart attack, up to 20% of patients may develop major depression.3 Individuals experiencing depression regularly exhibit elevated inflammatory markers and autonomic dysfunction, which can quicken CAD progression. Furthermore, depression is related to lifestyle factors like smoking, physical inactivity, and poor nutrition, all of which heighten cardiovascular risk.4

Cultural attitudes towards mental health, regularly influenced by stigma and traditional beliefs can also impede on the diagnosis and treatment of depression. These elements emphasize the necessity for appropriate interventions and highlight the significance of public health initiatives aimed at enhancing healthcare accessibility and support for communities grappling with both depression and CVD. This paper examines the prevalence, related risks, treatment options for depression in CVD patients, as well as the potential advantages of implementing systematic depression screening within cardiology practices.

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