A new study spearheaded by a long-time cardiology physician assistant (PA) provides evidence for the importance of proactive depression screening for coronary artery disease (CAD) patients. With Florida State University scientists, PA and co-author of the new study Aimee Pragle strives to provide a resource for clinicians to better approach the treatment of CAD and depression when they occur together.
Pragle says that screening for depression is just as important as screening for cholesterol and blood pressure levels in the context of heart disease, this according to recent research as well as years of experience as a cardiology PA.
"Studies show that only 30 percent of CAD patients who meet the criteria for diagnosis of major depression are actually diagnosed,” Pragle explained. “This demonstrates the need for continued education of clinicians in understanding how to identify and manage depression in patients with CAD."
While scientists have a lot to learn about the causal relationship between depression and CAD, there are theoretical explanations. For example, it could be that depressive CAD patients may be less likely to follow-through with taking prescriptions and working on preventative care. Working to lower cholesterol and blood pressure readings to a healthy level and making healthier diet and lifestyle choices can reduce the risk of future heart disease as well as limit the progression of existing disease.
Pragle and others conducted a survey of data on “epidemiological and clinical factors” that showed them how vital depression screening is to include in a CAD therapeutic plan. Pragle recommends diagnosing depression as early as possible to lower the risk of death. On average, people with both CAD and depression have poorer health outcomes compared to people who have none or just one of the conditions. Additionally, one study suggests having both conditions doubles the risk of death.
The new study, published in the Journal of the American Academy of Physician Assistants, also works to define the criteria for diagnosing depression, describe available screening tools, and recommend treatment options.
CAD is a form of heart disease where plaque builds up inside of the coronary arteries, blocking the adequate flow of blood, which carries oxygen and nutrients to the heart and all of the tissues of the body. Plaques can rupture and lead to blood clot formation, which can block blood flow completely, leading to a heart attack or stroke.
Depression is classified as a mood disorder that impacts how a person feels, thinks, and handles regular, daily activity. Risk factors for depression include family history of depression, trauma or stress, physical illness, and medications.