Depression linked to heart deaths.

Depressed older people die from heart disease much more often than their depressionfree peers, a new study finds. This result applied to depressed individuals who began the study either with or without heart disease, according to a report in the March ARCHIVES OF GENERAL PSYCHIATRY.

Several factors may contribute to cardiac fatalities among depressed people, suggests a team led by Brenda W.J.H. Penninx of Wake Forest University School of Medicine in Winston-Salem, N.C. Likely culprits include lack of exercise, poor eating habits, and unwillingness to comply with depression treatment, as well as physiological disturbances of heart function caused by depression, the scientists say.

Despite the new study's linking of depression and cardiac deaths, it's too soon to include the diagnosis and treatment of depression in programs to prevent heart disease, remark Robert M. Carney of Washington University School of Medicine in St. Louis and his colleagues in the same journal. Many depressed people deemed physically healthy at the start of the new study may actually have had subtle heart or blood vessel problems that went undiagnosed but were then magnified by their mood disorder, these researchers note.

Penninx and her coworkers recruited 2,847 men and women, ages 53 to 85, from throughout the Netherlands. Medical records yielded evidence of either coronary heart disease or congestive heart failure in 450 participants. About 1 in 50 people reported recent symptoms of major depression, such as feeling helpless, hopeless, and apathetic. Another 1 in 7 reported less severe symptoms of depression.

Over the next 4 years, depressed people experienced a markedly higher cardiac-death rate. Heart fatalities occurred most often among volunteers with major depression. Depressed individuals who had no prior heart disease died of cardiac disease at nearly the same rate as those who began the study with heart problems.

Volunteers' sex, education, cigarette and alcohol use, blood pressure, weight, and psychiatric symptoms other than depression had no bearing on the results, the researchers add.