Severe mental illness may increase the risk of death in men with heart failure

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Men with heart failure have worse long-term survival in severe depression, bipolar disorder and schizophrenia, according to a new study that is encouraging doctors to change treatments for people with mental illness.

Previous studies have shown that people with these conditions suffer from high blood pressure, diabetes, and heart attack. But little was known about how to do it. Heart failure If the heart is unable to pump enough blood to meet the body’s needs, it is calculated in an equation. The new study was published in the journal of the American Heart Association on September 30. Circulation: Heart failure..

Researchers surveyed more than 20,000 people with heart failure at the Duke University Health System between 2002 and 2017. Over the median follow-up of 7 years, depression, bipolar disorder, or schizophrenia were 36% more likely to die for. some reason than those who did. not. The 10-year risk of death fell from 54.8% for men without mental illness to 64.3% for men with mental illness.

However, in the case of women, researchers did not see a significant difference in the risk of death between those with and without severe mental illness. obstacle to health.

The study found that people with severe depression, bipolar disorder and schizophrenia were on average seven years younger when diagnosed with heart failure than those without. 60 years against 67 years. Heart devices and transplants had a high postoperative mortality rate.

Lead author of the study, Dr Christopher Polkwiartek, said doctors and heart failure professionals need to be more aware of their patients’ mental health issues and take precautionary measures early.

To reduce the overall burden of heart failure in this population, Polwiartek has encouraged heart failure specialists to work with psychiatrists, heart rhythm specialists and general practitioners to take an interdisciplinary approach.

The study points out that the European and US guidelines for the treatment of heart failure recommend screening and treatment for depression, but not other serious mental illnesses. obstacle .. Polwiartek, a medical intern at Danish University Hospital Arvorg, said his advice needed updating. “The guidelines should emphasize that not only depression, but certain mental illnesses of all kinds are associated with a poor prognosis for long-term heart failure.”

James Blumental, Clinical Psychologist Those who did not participate in the study said it was an important study suggesting that doctors should assess the patient’s mental health in addition to assessing risk factors for more traditional heart failure. I called.

But the results raised more questions than answers, he said.

“Why Do Serious Mental Illnesses Increase Men’s Risk of Heart Failure? Why was there no difference in mortality between women with and without severe mental illness? Women compared to men Were you more likely to receive psychiatric treatment? “Bromental, JP Gibbons, professor of psychiatry and behavioral science at Duke University School of Medicine in Durham, NC, said. To answer these questions, he said, more investigation is needed in multiple contexts that represent a wide range of people from different backgrounds.

Considering less than 20% of critically ill patients, Blumental said the results also raise the question of whether the mental condition was treated properly. Mental illness I was taking antidepressants or antipsychotics.

“The lack of awareness and treatment of their mental condition by sick patients is a serious problem that needs more attention,” he said.

In January, the AHA issued a scientific statement urging doctors to assess the mental health of all patients with heart disease and consider prescribing medication or psychotherapy as part of their routine care.

“Clinicians should strive to treat the whole person, not just the disease,” the statement said.

While the new study highlights the need for healthcare professionals to pay close attention to the links between heart failure and mental health, patients must also be vigilant, Blumental said.

People with mental illness and their loved ones should “monitor their condition, such as eating a healthy diet, taking prescribed medications, and seeing a regular doctor to adopt important health behaviors.” We must recognize the importance of this. ”Low salt diet and regular exercise.


Mental illness associated with worsening results of a heart attack


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