Depression increases cardiac risks in older women

A sunny outlook may go a long way toward keeping your heart healthy, at least for some women.

Research suggests that mild and moderately depressed women are 50 percent more likely to die of a heart attack than their happier counterparts. And though scientists don't have all the answers as to how depression and heart disease might be related, they are certainly asking the questions.

"There's got to be a physiological link, and people are trying to look at it," Sylvia Wassertheil-Smoller, a professor of epidemiology and population health at the Albert Einstein School of Medicine in New York City , told HealthDay .

In a study led by Wassertheil-Smoller, researchers examined the medical records of 93,676 postmenopausal women aged 50 to 79. They tracked participating women for an average of four years.

But unlike many women's heart studies, which include participants who've already had a heart attack, the women in this study were healthy when the research began. About 15 percent of them eventually were diagnosed with depression. Depression occurred most often in women in their 50s; symptoms dropped by ages 70 to 79.

"Maybe by the time you're getting to be 70 to 79, you're accepting life and it doesn't get you down so much," Wassertheil-Smoller said. Those diagnosed with depression were treated with antidepressants.

The researchers found that even though their symptoms were mild or moderate -- perhaps, they said, because of the antidepressant medication -- the depressed women were 50 percent more likely to die of a heart attack and 30 percent more likely to die of other causes. Death rates for the depressed women were higher regardless of whether they smoked or were overweight, the investigators noted.

The study did not reveal the whys of the depression-heart disease link, but Wassertheil-Smoller speculated that depression may increase inflammation or impede blood clotting. Or, she said, depression could serve as a "sentinel symptom," warning the body about impending heart problems.

Dr. Francine Welty, director of cardiovascular care for women at Beth Israel Deaconess Medical Center in Boston , cautioned that doctors should take the link between heart disease and mental health seriously. Of particular risk, she said, may be women who find themselves alone.

"A lot of my older female patients with heart disease no longer have their spouse or they may be divorced, have little family support," Welty told HealthDay .

The good news, Welty said, is that exercise can go a long way in helping women fight both depression and heart disease.

"No matter what their age, they need to get out there and do aerobic exercise," she said. "Walking is sufficient. Studies have shown that walking is as beneficial as other exercise."