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The last eight years of research for Heidi May have been an exploration of "which came first, the chicken or the egg?"
The chicken, in May's case, is depression and the egg is coronary heart disease. Her new study shows that patients are twice as likely to die if they develop depression after a heart disease diagnosis.
The epidemiologist and her team at the Intermountain Medical Center Heart Institute researched the data of about 25,000 Intermountain patients who were tracked for up to 10 years after being diagnosed. Not only did the research find depression was the strongest indicator of mortality in heart disease patients, but the team also discovered a prolonged risk of developing depression.
May wanted to explore the correlation further by researching the longterm effects of depression on those with coronary heart disease. Although there is plenty of research linking depression and heart disease, May said her findings still shocked her.
"I thought there would be a more pronounced risk (of depression) in the months following a coronary heart disease diagnosis, but I was surprised how the risk continued throughout follow up," she said. "I didn't expect to find such a consistent relationship."
The team researched several other predictors of mortality such as age, sex, diabetes and high blood pressure, none of which coming close to depression's indication of death May said. Half of the patients who were diagnosed with follow-up depression died during the study period, as oppose to the 38 percent of patients who died who didn't develop depression.
The study puts the importance of screening heart disease patients for depression on display, May said, calling for continued screenings beyond the first couple years post-diagnosis.
For David "Larry" Steed, keeping his situational depression in check will ultimately help him continue caring for his wife of nearly 62 years. Steed, 82, received a six-way bypass surgery about 15 years ago but only after his wife's health declined did he realize depression was affecting him.
Although he remains diligent about his heart health, his wife's worsening condition has required Steed to reduce some of his physical activity, such as regular walks, to tend to her needs. Steed was reluctant to bring up the symptoms he was exhibiting — the former Air Force fighter pilot said he felt he could face anything — but he has since been prescribed an antidepressant to help offset his symptoms.
"My cardiologist has been very concerned with all aspects of my health," Steed said. "I see him about every three months and he is right on top of this depression thing."
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