Psychological support has been shown to prevent readmissions in heart disease patients.

Research suggests that psychological support protects heart disease patients from readmissions and emergency department visits.

But senior Australian clinicians say accessing that support is a huge challenge, especially for Indigenous people living in remote parts of the country.

Cardiologist and Heart Foundation Chief Medical Advisor Professor Garry Jennings said mental health support was a “fairly routine part of cardiac rehabilitation” but that uptake of cardiac rehabilitation among people who have had a cardiac event in Australia was low. Stated.

“Everyone is emotionally shaken by a heart attack or hospitalization and everyone needs some support,” he said. TMR.

“Many people who need it don’t sing out loud after an event. They’ve received good physical care for their symptoms, but how much has it affected them mentally? You may not even realize it yourself.”

A US study of more than 1,500 adults with coronary artery disease, heart failure, anxiety and depression found that those who received both psychotherapy and antidepressants were less likely to be readmitted during the three-year study period. was found to be 75% lower.

They were also 74% less likely to visit the emergency department and 66% less likely to die from any cause.

Psychotherapy treatment alone reduced the risk of readmission by 49% and emergency department visits by 53%. Medication treatment alone reduced readmissions by 58% and emergency department visits by 49%.

“These findings demonstrate that mental health interventions are essential to reduce hospitalizations and emergency department visits for patients with heart failure, coronary artery disease, and associated depression and anxiety.” the researchers said in their paper. American Heart Association Journal.

Researchers said heart patients should also be tested for anxiety and depression.

“Patients with a confirmed diagnosis of anxiety or depression should not only treat their primary mental health diagnosis, but also receive appropriate treatment to improve cardiovascular disease outcomes, Collaborative care should be established between cardiovascular specialists and mental health professionals to promote the disease. ”

Approximately 92% of study participants had been diagnosed with anxiety and 55% with depression before admission.

Professor Jennings said study participants who received psychological support may have belonged to higher socio-economic groups or had better access to psychological or clinical support.

“There are many people who should be able to access psychological support after an event, but they don’t, and that’s especially true for indigenous peoples who live in remote areas,” he said. TMR.

“Unless you’re very lucky, accessing mental health support in Australia isn’t that easy.”

He said general practitioners played an important role in checking patients’ mental health after cardiovascular events.

“Be prepared to seek help from a psychologist or other medical professionals who can help,” he said.

Professor Jennings said there were a variety of reasons why people with heart disease would be better off with mental health support.

“When you’re in a better frame of mind, you’re more likely to take your medications, you’re more likely to go to appointments, you’re more likely to follow nutrition and physical activity guidelines,” he said.

“It may also help you quit smoking.”

Professor Jennings pointed out that because the study was a retrospective cohort study, it could not show cause and effect.

According to the study authors, heart disease, depression, and anxiety significantly impair quality of life and are “mechanically linked in such a way that each contributes to the progression of the other and further contributes to poor quality of life.” “I’m here.”

“Indeed, comorbid depression leads to perceived severity of symptoms that exceeds actual measures of functional impairment,” the researchers wrote.

Lead author Philip Binkley, vice chair of internal medicine and professor emeritus of internal medicine and public health at The Ohio State University, told the media there appears to be a psychological mechanism linking heart disease to anxiety and depression. We are currently investigating.

“Heart disease and anxiety/depression are both associated with activation of the sympathetic nervous system,” he said.

“This is part of the so-called involuntary nervous system, which increases heart rate and blood pressure and can also contribute to anxiety and depression.

“Our findings motivate cardiologists and health care professionals to regularly screen for depression and anxiety, and demonstrate that collaborative care models are essential for managing cardiovascular and mental health. I hope so.”

American Heart Association Journal 2024, online March 20