Magazine article Clinical Psychiatry News

'Perfect Storm' of Depression, Stress Raises Risk of MI, Death

Magazine article Clinical Psychiatry News

'Perfect Storm' of Depression, Stress Raises Risk of MI, Death

Article excerpt

FROM CIRCULATION: CARDIOVASCULAR QUALITY AND OUTCOMES

Patients with coronary heart disease who have both depression and stress are at increased risk of myocardial infarction and death, according to findings from a large, prospective, cohort study.

Of 4,487 adults with CHD who were part of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, 1,337 experienced MI or death during a median of nearly 6 years of follow-up. Those with both more depressive symptoms and stress at baseline--about 6% of the study population--were at significantly increased risk of such events (adjusted hazard ratio, 1.48) during the first 2.5 years of follow-up, compared with those with less stress and fewer depressive symptoms. However, the association was not significant beyond the initial 2.5 years (HR, 0.89), Carmela Alcantara, Ph.D., of Columbia University, New York, and her colleagues reported (Circ. Cardiovasc. Qual. Outcomes 2015 March 10 [doi; 10.1161/ IRCOUTCOMES. 114.001180]).

The findings provide initial empirical evidence to support a "psychosocial perfect storm conceptual model" based on the idea that it takes an underlying chronic psychosocial vulnerability such as depression along with a more transient state such as psychological stress to precipitate a clinical event, they said. …

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