Depression after a heart attack is relatively common and those who are depressed have an increased risk of suffering another heart attack or dying. However, a new study has found that exercising and quitting smoking can improve depression in those affected.

European researchers looked at over 1,100 people taking part in a heart study. They assessed the impact of a number of factors which were thought to improve depression after a heart attack, including quitting smoking, reducing alcohol consumption, exercising more and better management of cholesterol levels.

The study found that after one year of follow-up, 27% of heart attack patients had new or persistent depression, while 11% had improved depression. Those with depression were more likely to be unmarried, have diabetes, and smoke compared to those without depression.

The researchers found that after one year, those who were more likely to see an improvement in their depression were those who had quit smoking. They had a 2.3 improved chance of seeing an improvement in their mental health compared to those who kept on smoking.

They also found that those who were more physically active from the beginning were more likely to see an improvement in their depression.

"Patients who are depressed after a heart attack have a two-fold risk of having another heart attack or dying compared to those who are not depressed. But heart attack patients who smoke and are depressed are much more likely to improve their depression if they kick the habit," commented Dr David Nanchen, of the University of Lausanne in Switzerland.

He said that while the study did not find that taking up exercise after a heart attack improved depression symptoms, ‘we did show that patients who were already physically active were more able to improve their depression'.

"More than one-quarter of patients in our study reported symptoms of depression after their heart attack, which shows this is a big issue. Some had chronic depression which started before their heart attack while others became depressed as an acute reaction to the hospitalisation and the event," Dr Nanchen explained.

The researchers also noted that depressive symptoms in heart patients can differ from psychiatric patients.

"Frequently they don't say they feel sad or hopeless but instead complain of insomnia, fatigue or body pain. The different clinical presentation contributes to the under-diagnosis of depression in cardiac patients," they pointed out.

They also noted that depression after a heart attack can lead to many issues, including poor adherence to treatment, skipping medical appointments, smoking, leading a sedentary lifestyle, consuming an unhealthy diet, social isolation and poor self esteem.

Details of these findings are published in the European Heart Journal.

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