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Medicines for depression, be careful if you suffer from heart

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The problem is always the same. Find out if the chicken or the egg is born first. It is not known whether it is depression and anxiety that determine a greater risk in those suffering from cardiovascular diseases, which has already been established, or if the treatments to control depression and anxiety can themselves be a factor that can influence the dangers for the health of heart patients. What is certain is that, even without determining a possible correlation and a clear cause-effect relationship but only a possible association, a Danish research coordinated by Pernille Fevejle Cromhout of the University Hospital of Copenhagen warns on this front. And it points out not only the importance of a psychological evaluation for people dealing with heart disease, but also the need for the cardiologist to consider any ongoing treatment for psyche problems. According to the study, published inEuropean Journal of Cardiovascular Nursing, the intake of these medicines is associated with a greater risk even if the same expert points out that further research is needed to “assess whether the increased mortality is due to the use of psychotropic drugs or to the underlying disease”.

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However, there is a further element to consider: not all patients with major cardiovascular diseases would have the same risk if they follow therapies to counter anxiety (the symptoms of which are present in about 30% of the subjects examined) or depression. , which often follows the diagnosis of significant heart disease. According to the survey, in fact, the use of drugs of this type was more widespread among women, the subjects more elderly people, i smokers, those left alone, those with lower levels of education and those with a higher number of concomitant pathologies. The study enrolled 12,913 patients hospitalized for ischemic heart disease, arrhythmias, heart failure, or valvular heart disease from the national survey DenHeart. Participants completed a hospital discharge questionnaire and were classified as having anxiety symptoms if they scored eight or more on the Hospital Anxiety and Depression Scale (HADS-A) anxiety rating. Alongside these observations, information on drug consumption was evaluated, drawing numbers from national registers. The subjects included in the research were defined as consumers of psychotropic drugs if they had had at least one prescription of benzodiazepines, antidepressants and antipsychotics in the six months preceding hospitalization for cardiovascular problems. Then the health of the people included in the research was monitored in the twelve months following their admission to the hospital. Result? Let’s go in order. The 18% of patients, nearly one in five, had a prescription for at least one pack of drugs intended to act on the psychological state: among the most used in these people there were benzodiazepines and classic antidepressants. The presence of anxiety was particularly significant, so much so that about one in three sufferers had to deal with problems related to this situation and precisely among the anxious the use of drugs was twice as high as in the others. 3% of the patients observed died in the first year of discharge, but the percentage rose to 6% among those who took drugs for anxiety, depression and other pathological conditions compared to 2% observed in those who had a “better” attitude in terms of psyche.

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According to the Danish scholar, even if further studies are needed, these indications must be carefully considered in the management of heart patients. “Heart disease patients suffering from anxiety should inform healthcare professionals involved in their treatment as they would any other coexisting condition,” she concludes. And they should also ask that their anxiety be recognized as important and equal to their heart disease ”.

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