Depression in Patients With Heart Failure: Prevalence, Pathophysiological Mechanisms, and Treatment

Detect depression in patients with heart failure using a symptom inventory and an interview to confirm the results.

As treatment of cardiovascular diseases improves and the population ages, the incidence and prevalence of heart failure are increasing. More than 5 million patients in the United States are living with heart failure, and 550 000 new cases are diagnosed each year.¹ The estimated prevalence of depression is 100 cases per 1000 persons in the population more than 65 years old.² Strong evidence^3,–11 links depression to increased morbidity and mortality in patients with coronary heart disease, the underlying cause of half of the cases of heart failure. Depression is associated with mortality in outpatients,^12,–15 inpatients,¹⁶ and hospitalized patients who have heart failure.^17,18 The association of depression with mortality in these patients is independent of anxiety and social isolation....