Depression in Patients with Heart Disease: The Case for More Trials

Abstract

Depression is common among patients with heart disease. It is an important comorbidity, both because of its well-known effect on the quality of life and also because it has a significant impact on the ability of patients with heart disease to engage in healthy behaviors and to avoid unhealthy ones. In addition, depression is associated with increased morbidity and mortality in those with established cardiovascular disease. However, no study has demonstrated that treatment of depression improves cardiac outcomes in patients with heart disease. Some have argued that additional trials are not necessary, and that the importance of depression argues for increased recognition and treatment even if it cannot be demonstrated that this improves morbidity and mortality. This article makes the case for more trials in this area, highlighting the importance of using the results of prior trials to generate hypotheses and provide directions for future studies in this area and noting the effect that demonstrating improved survival might have on clinical practice.

Keywords:

• antidepressant treatment
• cardiovascular disease
• depression
• mortality
• randomized controlled trial

Financial & competing interests disclosure

Roy C Ziegelstein is supported by grant R24AT004641 from the National Center for Complementary and Alternative Medicine and by the Miller Family Scholar Program of the Johns Hopkins Center for Innovative Medicine. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Roy C Ziegelstein is supported by grant R24AT004641 from the National Center for Complementary and Alternative Medicine and by the Miller Family Scholar Program of the Johns Hopkins Center for Innovative Medicine. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.