Depression and bipolar disorder are strongly associated with heart disease. People with established heart disease are at higher risk of developing depression.
At The London Psychiatry Centre on Harley Street, we offer a cardiovascular screening programme in association with Dr Robin Roberts, Consultant Cardiologist.
Following a heart attack or cardiac surgery, individuals who become depressed have a worse short-term and long-term outcome compared to people who are not depressed. In the UK people with depression and bipolar disorder are not routinely screened for heart disease and people with heart disease are not routinely screened for depression.
Get to the heart of depression.
Early detection of cardiovascular disease (CVD) enables early intervention with treatments known to improve long-term health. Early detection and treatment of depression can reduce the risk of developing heart problems.
CARDIOVASCULAR DISEASE AND BIPOLAR
A Swedish study looked at all cases of bipolar disorder diagnosed in that population between 1987 and 2006. Although deaths from suicide, accidents and homicide were nearly 10 time higher than in the general population, these deaths accounted for only 18% of total mortality. At 37%, deaths from CVD were more than double this figure.
Patients with CVD and bipolar disorder die around 10 years earlier than those with CVD in the general population. For bipolar disorder hospital admission rates for CVD were only a little above average, even though the chances of dying are doubled. This under-treatment of CVD in the bipolar population points to a failure of the healthcare system to identify and address the health needs of those patients.
Depression affects 1 in 10 adults, but up to 1 in 3 people who have had a heart attack.
Depression raises levels of “stress” hormones; cortisol, growth hormone and adrenaline. These cause a rise in blood pressure and levels of cholesterol and sugar, which are risk factors for cardiovascular disease. Unmanaged stress can lead to arterial damage, irregular heart rhythms and a weakened immune system.
The continued presence of depression after recovery from a heart attack or cardiac surgery increases the risk of death within the first 6 months by five-fold when compared to individuals who are not depressed.
For people with heart disease, depression can increase the risk of an adverse cardiac event such as a heart attack or blood clots.
For people who do not have heart disease, depression can also increase the risk of a heart attack and development of coronary artery disease.
Negative lifestyle habits associated with depression – such as smoking, excessive alcohol consumption, lack of exercise, poor diet and lack of social support – interfere with the treatment for heart disease and people with untreated depression or bipolar disorder are less likely to continue taking medication or adhere to healthy lifestyle changes.
For these reasons, we believe that it is very important to screen for CVD in individuals with depression or bipolar disorder and to screen for depression in individuals with CVD.
Matatizo ya moyo na bipolar yana uhusiano mkubwa na ugonjwa wa moyo. Watu walio na ugonjwa wa moyo wenye kudumu wana hatari kubwa zaidi ya kupatwa na mshuko wa moyo. Kituo cha Psychiatry cha London, Harley Street, kina programu ya uchunguzi wa moyo na mishipa ya damu, pamoja na Daktari Robin Roberts, Mshauri wa Mwili. Baada ya kushikwa na mshtuko wa moyo au upasuaji wa moyo, watu wanaoshuka moyo wana matokeo mabaya ya muda mfupi na ya muda mrefu ikilinganishwa na watu ambao hawana mshuko wa moyo. Watu wenye ugonjwa wa moyo na ugonjwa wa bipolar hawapimwa mara kwa mara kwa ugonjwa wa moyo. Fikia kiini cha mshuko wa moyo. Ugunduzi wa mapema wa ugonjwa wa moyo (CVD) huwezesha uingiliaji wa mapema na matibabu yanayojulikana kuboresha afya ya muda mrefu. Kugundua na kutibu mshuko wa moyo mapema kunaweza kupunguza hatari ya kupatwa na matatizo ya moyo. Utafiti uliofanywa nchini Sweden ulichunguza visa vyote vya ugonjwa wa bipolar vilivyogunduliwa katika idadi hiyo ya watu kati ya mwaka wa 1987 na 2006. Ingawa vifo vya kujiua, ajali na mauaji vilikuwa karibu mara kumi zaidi kuliko katika idadi ya watu kwa ujumla, vifo hivi vilikuwa na uwiano wa 18% tu wa vifo vyote. Kwa mujibu wa ripoti hiyo, vifo vya watu wanaosababisha ugonjwa wa moyo na mishipa ya damu vilikuwa mara mbili ya vifo vya watu wengine. Wagonjwa wenye ugonjwa wa moyo na ugonjwa wa bipolar hufa miaka 10 mapema kuliko wale walio na ugonjwa wa moyo na ugonjwa wa moyo katika idadi ya watu. Kwa sababu ya ugonjwa wa bipolar, viwango vya uandikishaji wa hospitali kwa CVD vilikuwa juu kidogo tu ya wastani, ingawa uwezekano wa kufa unazidi mara mbili. Ugonjwa wa CVD katika idadi ya watu wenye ugonjwa wa bipolar unaonyesha kushindwa kwa mfumo wa huduma za afya kutambua na kushughulikia mahitaji ya afya ya wagonjwa hao. Ugonjwa wa kushuka moyo huathiri mtu mmoja kati ya watu wazima kumi, lakini hata mtu mmoja kati ya watu watatu ambao wamepatwa na mshtuko wa moyo. Mshuko wa moyo huongeza viwango vya homoni za "mkazo"; cortisol, homoni ya ukuaji na adrenaline. Hii husababisha kuongezeka kwa shinikizo la damu na viwango vya kolesteroli na sukari, ambayo ni sababu za hatari ya ugonjwa wa moyo na mishipa ya damu. Mkazo usioweza kudhibitiwa waweza kusababisha uharibifu wa mishipa ya damu, mshtuko usio wa kawaida wa moyo na mfumo wa kinga dhaifu. Kuendelea kuwa na mshuko wa moyo baada ya kupona baada ya mshtuko wa moyo au upasuaji wa moyo huongeza hatari ya kifo katika miezi sita ya kwanza kwa mara tano ikilinganishwa na watu ambao hawana mshuko wa moyo. Kwa watu wenye ugonjwa wa moyo, unyogovu unaweza kuongeza hatari ya tukio lisilofaa la moyo kama vile mshtuko wa moyo au kuganda kwa damu. Kwa watu ambao hawana ugonjwa wa moyo, kushuka moyo pia kunaweza kuongeza hatari ya mshtuko wa moyo na ugonjwa wa mishipa ya moyo. Mazoea mabaya ya maisha yanayohusiana na unyogovu - kama vile kuvuta sigara, kunywa pombe kupita kiasi, ukosefu wa mazoezi, lishe mbaya na ukosefu wa msaada wa kijamii - huingilia matibabu ya ugonjwa wa moyo na watu wenye unyogovu usiotibiwa au ugonjwa wa bipolar ni uwezekano mdogo wa kuendelea kuchukua dawa au kufuata mabadiliko ya maisha yenye afya. Kwa sababu hizi, tunaamini kuwa ni muhimu sana kuchunguza CVD kwa watu wenye unyogovu au ugonjwa wa bipolar na kuchunguza unyogovu kwa watu wenye CVD.