Mending a broken heart: loving support from those close to you aids in recovery from heart attack.

The poets, the songwriters, and the romance writers have had it right all along Love can mend a broken heart.

"You bet. It's true," says Bob Switzer, who has suffered two major heart attacks, but credits the love of his family and the support of his friends for helping him survive.

One scientific study after another has shown that people who suffer heart attacks have a better chance of surviving those attacks and of living a fuller life if there is someone to lean on during their health crisis.

Heart attacks, according to the American Heart Association remain the biggest killers of men and women in the United States. The AHA estimates that someone in the U.S. suffers a heart attack every 20 seconds, which adds up to 1.5 million heart attacks a year. About one third die.

Experts report that one of the keys to surviving a heart attack is what happens when you get home from the hospital.

"Doctors have often wondered why some people who have a good medical outlook do not survive a heart attack, while others with a much poorer prognosis pull through this period," says Lisa Berkman, Ph.D., professor of epidemiology at the Yale School of Medicine in New Haven, Connecticut.

"We recently found that men and women who said they had no emotional support from either family or friends were more than twice as likely to die following a heart attack as those who have emotional support," Berkman said.

She and her researchers looked at possible reasons that those without emotional support tended to die at twice the rate of others Were they older? Were they sicker with other illnesses? Were their heart attacks more severe? Were they more depressed? Were they poorer economically?

But Berkman could not find any other factor that contributed to the risk aside from the lack of emotional support. Her study isn't the first to note the relationship between emotional support and survival.

"Over the past 15 years there have been at least eight large studies indicating that social isolation is related to increased mortality risk," she said. "It seems that just knowing someone is there may make a difference to the heart attack patients."

"I think it has made a difference to me," says Switzer, 60, a retired broadcast executive who was first hit by a massive heart attack when he was 49 "and I've seen that just knowing there is someone out there who cares about you makes a difference to a lot of other people as well."

"My wife and I struggled through the first heart attack and recovery by ourselves," says Switzer who lives in Phoenix. In 1992 came the second heart attack, followed by coronary artery bypass surgery in which blockages in five blood vessels had to be bypassed. As he tried to overcome the twin traumas, Switzer was introduced to the national organization Mended Hearts a support group for people undergoing heart surgery or recovering from heart attack.

Switzer now president of the Phoenix chapter said, "The people from Mended Hearts provided support from people who had been through the same thing and knew what your fears were and, more important, could tell you what to expect and how it would affect your life down the road."

Switzer says the experience helped him through the anxiety and depression that "comes from having to suddenly confront your own mortality."

He said the support groups "can affect the outcome for patients. It is worthwhile. I've seen some people who were so depressed about their condition that they believed they would die in the hospital. We know that having a bad heart and being depressed is a deadly combination.

"Having someone to share the experience of going through a heart attack, recovery, and heart surgery can help shake that depression. I think it can help save a person's life. I'm sure it has saved many people in our own group and in similar groups around the country."

Switzer has been to hospitals dozens of times to visit people recovering from heart attacks or heart surgery and has observed "If a person goes in with a positive attitude, it seems that they have fewer complications. But if they are depressed and have negative feelings, they'll usually have a more difficult time."

While Switzer's observations aren't scientific tests, many recent studies, such as Berkman's, back him up.

* A 32-year study of 2,280 men suggests that anxiety may be a risk factor for sudden cardiac death. Although scientists aren't sure why it happens, a team of Boston doctors reported that intense psychological stress may trigger electrical disturbances in the heart, and these episodes of irregular rhythm lead to sudden heart death.

* A Mayo Clinic study found that psychological distress was the strongest predictor of future cardiac events, such as cardiac death, cardiac arrest, and heart attack.

* A study from the Oschner Clinic in New Orleans found that patients who have had a heart attack don't do as well if they are depressed. These patients have a higher rehospitalization rate, a higher mortality rate, and overall do poorly when compared to the nondepressed population.

* A study at the Montreal Heart Institute has shown that depression that follows a heart attack continues to increase the risk of dying during an 18-month period. This study also found that by treating depression, the risk of dying from a heart attack may decrease.

* Researchers at Johns Hopkins Medical Institutions in Baltimore have found that depression is an independent predictor of cardiovascular disease. These researchers found that the increased risk remained even after they accounted for risks caused by other factors such as age physical inactivity, high blood pressure, smoking, and diabetes.

Daniel E. Ford, M.D. M.P.H., assistant professor of medicine, epidemiology, health policy, and management at Johns Hopkins, said "We still need to find out if treatment of depression reduces the risk of heart attack."

For Bob Switzer the answer is evident "I'm living proof that if you have support, you can overcome depression and you can survive your heart attack or heart surgery. It has worked very well for me."