Links between mental and heart health

Experiencing a cardiac event or being diagnosed with a cardiac condition can have a profound psychological effect on patients. Not only are acute cardiac events followed by emotional distress, but there are also important psychological consequences for patients with an implantable cardioverter-defibrillator (ICD), both post-surgery and in daily life. Chronic heart failure and depression commonly co-exist, and a person's personality even appears to play a role in cardiovascular disease.

This issue's column will outline some of the psychological effects of cardiac conditions and events, and how nurses might best support patients. My next column will delve deeper into depression in heart failure, and the role of personality in heart and circulatory diseases.

Unfortunately, rates of depression and anxiety have been reported to be 20–30% after a cardiac event, and rates of post-traumatic stress disorder and suicide are also elevated (Jackson et al, 2018a). People with cardiac conditions who are distressed have been found to be less adherent to lifestyle recommendations, are more likely to smoke or relapse after quitting, consume more dietary fat and engage in less physical activity (Jackson et al, 2018a). Unsurprisingly, cardiac patients who are depressed or anxious also face a higher risk of hospital readmission, recurrent cardiac events, and premature mortality (Jackson et al, 2018a).