Hypertension and Depression risk factors for heart disease in elderly.




Archives of Internal Medicine

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The heart needs oxygen and nutrients to function just like any other muscle in the human body. When the arteries that carry blood to and from the heart become clogged or blocked, the consequence is coronary heart disease (CHD). This disease can lead to chest pain called angina, or heart failure. If the arteries become completely blocked, a heart attack can occur. Since the heart at that time is not receiving the critical oxygen it needs to survive, there is a risk of permanent damage to the heart muscles. CHD can be induced by high blood cholesterol which affects the level of build-up in the arteries. Others factors that contribute to this disease are smoking, high blood pressure (hypertension), obesity, or physical inactivity. CHD is the most common type of heart disease and of the 7 million Americans who suffer from it, half a million die each year from heart attacks.1

According to the American Heart Association, 84% of CHD deaths are Americans over the age of 65 years.2 Researchers at the Emory University School of Medicine in Atlanta, Georgia decided to examine the link between depression, hypertension, and CHD in older people. The authors stated that in previous studies, depression has been shown to correlate with CHD and particularly with heart attacks. The study examined 4,538 people over the age of 60 and suffering from hypertension. The depression in these individuals was based on the Center for Epidemiological Studies Depression Scale (CES-D). 221 individuals were diagnosed as depressed, and 4,317 were non-depressed. After a 4.5 year follow-up, heart failure occurred in 138 (3.2%) of the non-depressed group, versus 18 (8.1%) of the depressed group. The researchers adjusted the results for age, race, medical history, sex, and cholesterol among others.

They found that the depressed group had more than a two-fold risk of heart failure compared to the non-depressed group. They concluded that among the elderly, depression was independently associated with heart failure in those diagnosed with hypertension.3


1. National Heart, Lung, and Blood Institute, National Institute of Health. Facts about Coronary Heart Disease. 1997.
2. American Heart Association. Biostatistical Fact Sheet --- Populations Older Americans and Cardiovascular Diseases.
3. Abramson J, et al. Depression and Risk of Heart Failure Among Older Persons With Isolated Systolic Hypertension. Archives of Internal Medicine. July 23 2001.