Depression takes its toll on patients with heart failure
Patricia Lea MSEd, RN

$1.99 		Nursing2013 Critical Care
January 2011 
Volume 6  Number 1
Pages 19 - 23
 
  PDF Version Available!

ABSTRACT
Depression is common in patients with heart failure, raising the risk that these patients will die prematurely. This article explores how early detection of depression in patients with heart failure can help increase patients' quality of life and overall survival.Although heart failure is common, the effects of depression in patients with heart failure haven't been studied extensively. Depression is common in patients with ischemic heart disease (IHD), with prevalence rates between 15% and 22%.1 The high rates of depression in IHD are important because depression has been strongly associated with increased cardiac events and mortality. Heart failure is an increasingly common consequence of IHD and hypertension, which are the major causes of morbidity and mortality among older adults. Patients with heart failure have shortness of breath, fatigue, peripheral edema, and reduced exercise capacity, and may be hospitalized repeatedly for acute exacerbations of the disease. Not surprisingly, these patients report a very poor quality of life. Depressed patients also are less likely to follow their treatment regimens, which can lead to adverse outcomes in coronary artery disease.1Recent reports on depression in patients with heart failure have cited prevalence rates ranging from 11% to 25% for outpatients and 35% to 70% for inpatients.1-11 What remains largely conjecture is why patients with heart failure display such a markedly increased prevalence of depression. In contrast, 5% to 19% of the general population is affected by depression.1-11 The wide range of prevalence rates across studies is likely due to the use of different diagnostic instruments and the inclusion of different patient populations in terms of age, sex, and disease severity.1-11 For example, depression may be more common in women with heart failure and in patients with more severe disease or worse physical symptoms.2One study found that 48% of 155 outpatients with heart failure were depressed.2 Patients who

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