NEW ORLEANS - Coronary heart disease may be the world's leading cause of death, but much of the damage is done by a silent killer we don't often consider: depression. Depression has been shown to have detrimental effects on millions of heart disease survivors every year, and is associated with a high mortality rate. In a study published in the September 2007 issue of The American Journal of Medicine, two Ochsner cardiologists, Drs. Richard V. Milani and Chip Lavie, show just how significant the benefits of cardiac rehabilitation can be on depression and mortality in patients with coronary heart disease.
"In this study, we're showing for the first time that reducing depression with cardiac rehabilitation for heart patients lowers mortality," explains Dr. Milani, Vice Chairman of Cardiology at Ochsner and the study's lead author. "Depressed patients who completed cardiac rehabilitation, had a 73 percent lower mortality risk compared to those who didn't undergo treatment." Specifically, the Ochsner researchers reported that cardiac rehabilitation therapy reduced prevalence of depressive symptoms by 50 to 70 percent.
In this study, 522 coronary patients were enrolled in cardiac therapy and evaluated and compared to 179 patients who didn't complete rehabilitation. Depressed patients who underwent cardiac rehabilitation therapy and subsequently became less depressed appeared to have lower mortality as did patients without depressive symptoms at either time. In contrast, patients who had depressive symptoms at both initiation and during rehabilitation had significantly higher mortality.
In addition to the other proven benefits of cardiac rehab, Dr. Lavie adds "this therapy also effectively reduces depression, and in many patients may prevent the need for anti-depressant medications, which have not been shown to reduce mortality." The full benefits of cardiac rehab for patients with depression and their survival can be achieved by a simple change in exercise capacity. "Many patients have shown tremendous benefits from exercise training with even small improvements in their overall levels of fitness," explains Lavie.
Approximately 20% of cardiac patients typically experience depression after a coronary event and without rehab, most of these patients continue to have depression with increased risk of subsequent cardiac events and higher mortality, including reduced quality of life. In the U.S., only about 5% of patients who qualify for rehab actually attend formal programs.
Ochsner Health System (www.ochsner.org) is a non-profit, academic, multi-specialty, healthcare delivery system dedicated to patient care, research and education. The system includes seven hospitals, a sub-acute facility, and 33 health centers located throughout Southeast Louisiana. Through our unique coordinated system, Ochsner provides healthcare with peace of mind because we put the needs of all patients first. Ochsner employs over 600 physicians in 80 medical specialties and subspecialties and conducts over 700 ongoing clinical research trials annually. Ochsner was ranked #1"Best Place to Work" by New Orleans CityBusiness Magazine in 2005 and 2006 and received the Consumer Choice for Healthcare in New Orleans for 12 years. Ochsner was ranked as "Best" Hospital by U.S. News and World Report in July 2007.
The American Journal of Medicine (http://www.amjmed.com), known as the "Green Journal," is one of the oldest and most prestigious general internal medicine journals published in the Unites States. AJM, the official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at125-plus U.S. medical schools, publishes peer-reviewed, original scientific studies that have direct clinical significance. AJM is published by Elsevier.