The Importance of a Healthy Mind in Patients with an Unhealthy Heart

Patients who have had acute coronary syndromes (ACS) are more likely to suffer from major depression than the general population with rates of clinically relevant symptoms of depression as high as 45%. Unfortunately, even if patients are routinely screened for depression with a PHQ-2 and PHQ-9 in primary care settings, appropriate treatments are often not initiated. Depression causes psychological stress which activates the sympathetic nervous system which leads to increased cortisol levels, inflammation, and platelet activation that can contribute to atherosclerosis and accelerate plaque formation. Thus, untreated depression may worsen cardiac outcomes.

Guest Authors: Hansita B. Patel, PharmD and Abigail L. Hulsizer, PharmD

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