Heart Attack Risk Factors: Depression and Sleep
Does your doctor have all the information she needs to protect your heart? If you haven’t heard about the latest heart disease markers, you probably haven’t told her enough to assess your true status. It turns out that seemingly unrelated conditions, such as depression and irregular sleep patterns, may increase your risk.
"Some risk factors have been under the radar," says Nieca Goldberg, MD, author of The Women’s Healthy Heart Program. "For example, if a patient comes into my office with chest discomfort and the obvious risk factors are normal, I’ll ask about menstrual regularity and whether she had any pregnancy complications, such as preeclampsia or gestational diabetes, because these are strong risks too. Most women don’t make the connection between their reproductive organs and their heart, but estrogen is a key factor in cardiac health."
Even if pregnancy and periods are distant memories, they still have an impact on your heart disease potential. "All risk factors are important over a lifetime, because the damage is cumulative," says C. Noel Bairey Merz, MD, medical director of the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center, in Los Angeles.
Scan this list, and if any of these scenarios apply to you, bring them up at your next visit to the doctor.
Clue 1: You’ve Experienced Depression
"Depression is the least-known widespread cardiac risk factor — as strong a predictor as smoking in some cases," says Sharonne N. Hayes, MD, director of the Women’s Heart Clinic at the Mayo Clinic, in Rochester, Minnesota. Women are about twice as likely to suffer from depression as men, so you’re at greater risk simply because of your gender. "We estimate that 20 percent of women are depressed at any given time, and about 50 percent of them are undiagnosed and untreated," says Andrew Farah, MD, chief of psychiatry at High Point Regional Health Systems, in North Carolina. One recent study found that postmenopausal women with symptoms of depression but no history of heart disease still had a 50 percent greater risk of developing or dying of heart disease than women without depression.
Depression also worsens your chances of survival once you have heart disease. In a study published in the Journal of the American Medical Association, depressed women who were hospitalized after a heart attack were three to five times likelier to die within six months. So can you lower your heart disease risk by treating your depression? According to Hayes, some studies suggest that you can, though more research is needed for a definitive answer.
Why it’s a risk factor: Depression can cause abnormal heart rhythms, elevated blood pressure, and stress-hormone levels, and faster blood clotting, all of which tax the heart. If you’re depressed, you may be less likely to take care of yourself and more likely to engage in unhealthy behaviors such as smoking and drug abuse, which also increase your heart disease potential. If you’re having unexplained physical symptoms such as prolonged headaches or fatigue, get screened for depression by your primary care provider. You can also self-screen online through the National Mental Health Association.
Clue 2: You Sleep Too Little — or Too Much
Screwed-up sleep can hurt your heart. A 2003 analysis of more than 71,000 women ages 45 to 65 in the Nurses’ Health Study found that sleeping five or fewer hours per night upped the risk for coronary disease by 45 percent. And those who regularly slept nine or more hours had a 38 percent greater risk than those who clocked eight hours — even after taking into account risk factors such as snoring and smoking.