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Depression in heart attack patients undertreated despite higher incidence in this group

Heart attack patients are more likely than others to experience depression, but less likely to be prescribed antidepressants.

Heart attack patients are more likely than others to experience depression, but less likely to be prescribed antidepressants.

The contradiction was uncovered in a survey of 805 under-75s who had experienced a first myocardial infarction. It found that 14% of heart attack patients had symptoms of depression, compared with 7% in a control group.

‘We know stress and depression are big risk factors for heart attack,’ said Barbro Kjellström of the Karolinska Institute in Stockholm. ‘But what was astonishing was that heart attack patients receive treatment for depression less often.’

Detailed information was collected on stress, depression and exhaustion at home and work. More patients than controls had experienced stress at home (18% compared with 11%) and at work (42% versus 32%). Even moderate levels of stress at home doubled the risk of heart attack.

Just 16% of heart attack patients with depression received antidepressants compared with 42% of controls with depression.

Dr Kjellström said: ‘The results suggest that heart attack patients are undertreated. We did not ask about cognitive therapies, but it is unlikely that the large gap in treatment was filled in this way.’

Overall heart attack patients did not seek help for depression, or if they did their symptoms were not accurately recognised and managed.

Reference

Rydén L et al (2016) Periodontitis increases the risk of a first myocardial infarction: a report from the Parokrank study. Circulation.

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