Can Treating Depression Improve Heart Health?

What you need to know

• Depression is associated with increased risk of heart disease, even in people without existing heart problems
• This study examined if treating depression with cognitive behavioral therapy (CBT) can improve biological markers of heart health
• CBT improved some measures of heart rate variability, which is linked to better cardiovascular health
• Patients with more severe depression showed greater improvements in heart measures after CBT
• More research is needed to confirm if improving these markers through therapy translates to lower heart disease risk long-term

The link between depression and heart health

Depression is not just a mental health issue - it can also affect physical health, particularly heart health. Research has shown that people with depression have a higher risk of developing heart disease, even if they don’t already have heart problems. Some of the biological factors that may link depression to increased heart disease risk include:

• Higher resting heart rate
• Lower heart rate variability (less variation in time between heartbeats)
• Higher blood pressure
• Higher levels of inflammation in the body

These factors are already present in many people with depression before any signs of heart disease. This has led researchers to investigate whether treating depression could potentially improve heart health and lower cardiovascular risk.

Exploring the effects of therapy on heart health markers

This study aimed to examine whether treating major depression with cognitive behavioral therapy (CBT) could improve biological markers related to heart health. CBT is a type of talk therapy that helps people identify and change negative thought patterns and behaviors.

The researchers recruited 80 people diagnosed with major depression who were not taking antidepressant medications. Participants were randomly assigned to either receive 14 weeks of CBT or be placed on a waiting list (the control group). The study also included 40 people without depression for comparison.

Before and after the treatment period, the researchers measured several biological markers in all participants:

• Heart rate and heart rate variability over 24 hours
• Blood pressure over 24 hours
• Inflammatory markers in the blood (C-reactive protein, interleukin-6, and tumor necrosis factor-alpha)

Key findings on heart health markers

Heart rate variability improvements

The most notable finding was that CBT led to improvements in some measures of heart rate variability. Heart rate variability refers to the variation in time between heartbeats. Higher variability is generally considered healthier and is associated with better cardiovascular health.

Specifically, the CBT group showed increases in:

• 24-hour heart rate variability triangular index
• Daytime heart rate variability triangular index

The heart rate variability triangular index is a measure of overall heart rate variability. These improvements suggest CBT may have positive effects on autonomic nervous system function and cardiovascular health.

Blood pressure changes

There was a trend toward decreased daytime systolic blood pressure (the top number in a blood pressure reading) in the CBT group compared to the control group. However, this did not reach statistical significance, meaning it could have occurred by chance.

Inflammatory markers

The study did not find any significant changes in inflammatory markers after CBT treatment. This suggests CBT may not directly affect inflammation levels, at least in the short term.

More severe depression linked to greater improvements

An interesting finding was that patients with more severe depression at the start of the study tended to show greater improvements in heart-related measures after CBT. Specifically, those with higher initial depression scores showed larger decreases in heart rate and larger increases in various measures of heart rate variability after treatment.

This suggests that people with more severe depression may experience more cardiovascular benefits from CBT. However, it’s important to note that CBT is beneficial for depression of any severity.

Conclusions

• Cognitive behavioral therapy for depression may improve some markers of cardiovascular health, particularly measures of heart rate variability
• People with more severe depression may experience greater improvements in heart-related measures after CBT
• Treating depression could potentially have positive effects on heart health, even in people without existing heart disease
• More research is needed to determine if these short-term improvements translate to lower risk of heart disease in the long run

This study provides early evidence that treating depression may have benefits for heart health. However, it’s important to note that this was an exploratory study with a relatively small number of participants. Larger studies are needed to confirm these findings and determine whether improvements in these biological markers actually lead to reduced heart disease risk over time.

Regardless of potential heart benefits, CBT remains an effective treatment for depression itself. Anyone experiencing symptoms of depression should speak to a healthcare provider about treatment options, which may include therapy, medication, or a combination of approaches.