Depression, not antidepressants, increases mortality risks in heart failure

DURHAM, N.C. -- People who are depressed have an increased risk of dying from heart failure, and a new study by Duke University Medical Center researchers may help explain why.

Analyzing more than 1,000 depressed patients with heart failure, the researchers found that it was the depression itself, not the patients' use of antidepressant medications that increased mortality risk.

The finding may provide additional evidence for the current national debate over whether the increased mortality seen in heart failure patients with depression is due to the depression itself or the medications prescribed to treat it, the researchers said.

The researchers, led by internist and psychiatrist Wei Jiang, M.D., said the finding also should help convince physicians who care for heart failure patients to pay closer attention to their patients' mental status, since these patients may be helped by aggressive therapies that target heart problems and depression. Jiang said many physicians who treat heart disease patients continue to pay too little attention to managing their depression.

"In our analysis, we found that heart failure patients who were depressed had 15 percent higher rate of death than those who were not depressed," said Jiang, who presented the results of the study on Monday, Nov. 13, at the annual scientific sessions of the American Heart Association, in Chicago. "Although patients who were taking antidepressants during the first admission to the hospital were more likely to die than the patients who were not taking antidepressants, the association was confounded by existence of depression.

She said that it is the depression, not the use of antidepressants, especially the newest class of antidepressants known as selective serotonin reuptake inhibitors that negatively affected the prognosis of patients with heart failure.

"The results provide further evidence that physicians who take care of heart failure pat

Contact: Richard Merritt
Duke University Medical Center

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