Depression, whether it's diagnosed or not, can have several negative effects on the health of cardiovascular disease (CVD) patients, according to new research presented April 7 at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2018 in Arlington, Virginia. 

At present, roughly 20 percent of CVD patients also suffer from depression. Patients with depression spend an average $4,381 more on healthcare expenses annually. Negative effects on CVD patients with depression include poor healthcare experiences, more use of healthcare resources and higher health costs, according to the researchers.

“While we don’t know which comes first—depression or cardiovascular disease—the consensus is that depression is a risk marker for cardiovascular disease, meaning if you have cardiovascular disease, there is a higher likelihood that you could also have depression, when compared with the risk in the general population,” said lead researcher Victor Okunrintemi, MD, MPH, with Baptist Health South Florida in Coral Gables, and colleagues.

The researchers conducted two studies to determine the health and impacts of depression on cardiovascular health.

The first study assessed patient experience, healthcare expenditures and resource use in a large study cohort of adult individuals with cardiovascular disease (CVD). The cohort was divided into two groups—those with and those without depression. A questionnaire was distributed among the group and patients not diagnosed with depression were assigned as being high-risk or low-risk for depression. 

When the groups were compared, the researchers found the high-risk group spent more money, both overall and in out-of-pocket expenditures than the low-risk group. Patients in the high-risk group were more likely to use the ER and more than two times likely to be hospitalized. Additionally, individuals in the high-risk group were more than five times likely to have a poor self-perceived health status and four times more likely to be unhappy with their healthcare.

“When we compared non-depressed patients to those who had been diagnosed with depression, we found those who were not depressed and yet had a higher risk for depression had worse healthcare experiences, increased use of the emergency room, poorer perception of their health status and a lower health-related quality of life than those who actually had depression,” the authors said. “That could be because people at high risk for depression simply haven’t been diagnosed and treated for depression yet.”

Using the same study cohort, the second study compared utilized health resources and health expenditures among heart attack patients with and without depression. The researchers determined patients who were diagnosed with depression were 54 percent more likely to be hospitalized and 43 percent more likely to have an ER visit, compared to patients not diagnosed with depression.