April 20, 2012

Vascular Health & Depression

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Robert Carlson, M.D By:

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Depression is a risk factor for people with peripheral arterial disease

(dailyRx News) Which comes first? Poor vascular health or depression? It appears that depression is tightly linked to the health of the blood vessels and onset comes along with risk factors from peripheral artery disease (PAD).

A new study finds that depression is common in patients with PAD, a circulation issue. These results suggest that a healthier lifestyle could then improve both conditions.

"Talk to your doctor about healthy lifestyle changes!"

Marlene Grenon MD., Assistant Professor in the division of vascular and endovascular surgery at University of California San Francisco (UCSF) and her colleagues Drs. Beth Cohen and Mary Whooley, recently reported results of a study aiming to better understand the relationship between depression and (PAD).

This study is part of a larger study aimed to understand the role of psychological disorders in patients with heart disease (The Heart and Soul Study, led by senior researcher and Professor of Medicine Dr. Mary Whooley).

PAD is a functional problem with a person’s circulation. The arteries in the pelvis and legs are restricted, and blood flow to the limbs is reduced, which can cause pain with walking and sometimes, loss of limb. Scientists are starting to realize that PAD is far more common than previously thought.

PAD is a lot like coronary artery disease (CAD), where blood flow is restricted to the arteries of the heart.

“PAD has at least twice the mortality that CAD has,” says Dr. Grenon in a recent interview, “and the healthcare costs related to medication use and hospitalization are greater for PAD than they are for heart disease.”

The two, PAD and CAD, can often go hand in hand according to Dr. Grenon, “When someone has PAD, it means that the blood vessels around the body are also very likely to be diseased too, For example, 62% to 90% of people with PAD also have CAD.”

According to Dr. Grenon’s research there are unhealthy lifestyle factors, like smoking and lack of exercise, that when taken into account with existing inflammation, can increase the risk of depression in patients with PAD. Dr. Grenon estimates that while depression could often lead to people smoking more, being less active, and therefore at a higher risk of PAD, a PAD diagnosis itself could possibly lead to depression because of a restriction in physical activity due to the painful symptoms of PAD.

Dr. Grenon’s study focused on depression in PAD patients. They looked at 1,024 CAD patients from the Heart and Soul Study and followed them for over 7 years. At baseline, 19% of all the patients reported depression. The study reported that 12.1% of patients with PAD had symptoms of depression compared to 7% of those who did not have PAD, showing that depression was more common in people with PAD.

Important factors that explained this association included diabetes, abnormal cholesterol levels, smoking and physical activity.

The study concluded that depression is a risk factor for developing PAD, which happens through poor health behaviors. However, there is good news to come out of this study as well. Dr. Grenon asserts, “Physical activity, good nutrition and managing stress could possibly improve the quality of life and the disease burden in patients with PAD.”

This research will be presented at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology 2012 Scientific Sessions in Chicago.

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Reviewed by: 
Robert Carlson, M.D
Review Date: 
April 16, 2012

Last Updated:
April 20, 2012