High blood pressure, smoking, obesity and diabetes are established risk factors for heart disease. And according to a panel of experts, there is enough evidence to suggest depression should be added to the list.
"Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome," said the recommendations, which are published as a scientific statement in the journal Circulation.
To arrive at the recommendations, experts looked at hundreds of studies examining the association between depression and heart disease. Ultimately, 53 studies and four meta-analyses were included in the review.
The findings that depression raised the risk of death from heart disease or heart attack "didn't surprise us," Robert M. Carney, a member of the panel and professor of psychiatry at the Washington University School of Medicine in St. Louis, said in a statement.
"Many studies have reported that depression predicts increased mortality, but it's rare to delve into this kind of research as deeply and as carefully as we have," he added. "Although we suspected we would find this link, having gone through all of these studies and conducted such a careful evaluation, we are more confident than ever that depression is a risk factor for mortality in people who have heart disease."
Carney noted that more studies are needed to say whether treating depression lowers risk of heart disease, as there have not been many studies examining this potential link.