People with heart failure have a significantly increased risk of death if they suffer with moderate or severe depression, the results of a new study indicate.

Heart failure is a potentially life-threatening condition which leads to the heart being unable to pump enough blood around the body. Symptoms include tiredness, shortness of breath, dizziness and swollen ankles and around 10,000 new cases are diagnosed in Ireland every year.

According to UK researchers, it is already well established that people with heart failure have a high risk of recurrent hospital admissions and death.

"Approximately 25% of patients admitted to hospital with heart failure are readmitted for a variety of reasons within one month. Within one year, most patients will have had one or more readmissions and almost half will have died," noted Prof John Cleland of Imperial College London.

Prof Cleland is chief investigator of OPERA-HF, an ongoing study which looks at patients hospitalised with heart failure. He and his colleagues wanted to assess the main reasons for hospital readmission and death among affected patients.

"This included social, mental and physical frailty, as well as comorbidities and the severity of heart failure. Depression has been reported to predict death in patients with heart failure but until now it was thought that this could be because depressed patients have more severe heart failure and more comorbidities," he explained.

An analysis of over 150 patients revealed that those with moderate to severe depression were five times more likely to die compared to those with no depression or only mild depression.

The results stood even when other factors were taken into account, such as age, high blood pressure and the severity of heart failure.

"Our results show that depression is strongly associated with death during the year following discharge from hospital after an admission for the exacerbation of heart failure. We expect that the link persists beyond one year," Prof Cleland said.

He pointed out that depression is common among people with heart failure, affecting between 20% and 40% of patients.

"Depression is often related to loss of motivation, loss of interest in everyday activities, lower quality of life, loss of confidence, sleep disturbances and change in appetite with corresponding weight change. This could explain the association we found between depression and mortality," he noted.

However, Prof Cleland said that despite the findings, he is ‘not in favour of immediately prescribing anti-depressants'.

"Studies suggest that they are not effective in reducing depression in patients with heart failure. Clinicians should, however, screen patients with heart failure for depression and consider referring those affected for counselling, he said.

He added that the recognition and management of depression ‘may reduce mortality for patients with heart failure'.

"More research is needed to find out what clinicians and patients themselves can do to manage depression. Better treatments for heart failure, co-morbidities as well as depression itself may be required."

Details of these findings were presented at Heart Failure 2015, the main annual meeting of the Heart Failure Association of the European Society of Cardiology, in Seville, Spain.

For more information on depression, see our Depression Clinic here