Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in modern times. Although CVD has long been associated with the development of depression, less is known about whether spouses of people with CVD are more likely to become depressed after such events.

In a recently published study, JAMA network open explored this topic and laid the foundation for future prospective research in this area.

study: Depression develops after a spouse’s cardiovascular event. Image credit: Chay_Tee/Shutterstock.com

depression and health

With a prevalence of 65%, depression is the leading mental health disorder worldwide, reducing quality of life and negatively impacting overall health.

Depression is associated with increased risk of cardiovascular disease, dementia, cognitive decline, and death.

How is CVD related to depression?

Both CVD and depression are more common in obese people and share inflammation in the immune system. When someone suffers from a cardiovascular disease such as a stroke or heart attack, their family members also suffer from mental stress, anxiety, and even depression.

The present study aimed to investigate the association between CVD and depression at the household level. This data was obtained from a national database maintained by the Japan Health Insurance Association (JHIA).

This includes approximately 40% of Japan’s working-age population, or 30 million people in this age group.

What did the research show?

Researchers found that of approximately 278,000 couples matched on key characteristics, the majority (95%) reported a CVD-related event in their male partner. The mean age of the patients was 58 years.

People whose spouse had cardiovascular disease were more likely to have diabetes, hypertension, or depression than other groups. The cumulative incidence of depression increased in the spousal group, ranging from 4% to 5% for men and women, respectively.

For spouses between the ages of 20 and 59, about 4% of spouses developed depression, compared to 3% of spouses 60 and older.

New-onset depression was observed in almost 2% of people. The risk of depression among spouses after a CVD was 13% higher than in the group without such an event.

This did not vary by age, gender, income, or previous CVD history.

However, the risk of depression was 13% to 15% higher after a spouse’s stroke or heart failure, but not after a heart attack.

Other potential confounders include smoking, alcohol use, exercise, or whether the index patient was taking blood pressure-lowering medications. However, none of these affected the spouse’s risk of depression.

The researchers also looked at possible interactions between these results and spouse health.

They tested body mass index (BMI), blood pressure, cholesterol levels, blood sugar levels, and kidney function. They found that the same increased risk emerged even after controlling for these factors.

This study supports the effect of spousal CVD events on depression, which may require caregiving for an ill spouse.

This can mean inevitable lifestyle changes, lack of other social interactions, disrupted sleep, and lack of exercise. All of these are associated with chronic psychological stress, which increases as the level and duration of care increases.

Financial challenges due to forced unemployment and additional care-related costs to manage a spouse’s needs are also a source of stress.

Finally, the grief of losing a spouse or the distress associated with having a loved one in an intensive care unit can lead to depression.

conclusion

“These findings highlight the importance of preventive care for mental health disorders in individuals whose spouse has experienced cardiovascular disease.”

By paying attention to possible confounders such as history of other diseases, personal health habits practices, and physical health parameters, this study fills the knowledge gap and provides stronger evidence.

Multidisciplinary clinical support systems at the community level need to be investigated as potential interventions to reduce this risk for spouses of CVD patients through a wide range of preventive care approaches.