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Psychological therapy which improves depression reduces subsequent CVD risk

Psychological therapy that improves a patient’s depression also reduces their subsequent risk of developing cardiovascular diseases

Psychological therapies (PT) for instance, cognitive behavioural therapy, represent a first-line treatment approaches in depression. However, there is convincing evidence of an association between depression and cardiovascular diseases (CVD). In fact, severe mental illness significantly increases the risk of CVD and CVD-related mortality, as does taking anti-psychotic medications. Whether successfully treating depression with PT might lower the subsequent risk of CVD is uncertain.

In the current study, researchers retrospectively examined a group of patients who had completed the Improving Access to Psychological Therapy (IAPT) primary care programme for depression. Individuals were initially free of CVD before entry into the IAPT and over 45 years of age. Regression models then estimated the association between improvement from depression and the risk of subsequent CVD events.

Psychological therapies and subsequent CVD events

A cohort of 636,955 individuals with a mean age of 55 years (65.6% female) had usable data for analysis. The researchers were able to follow these individuals for a median of 3.1 years and 58.6% had an improvement in their depression.

In fully adjusted models, improving depression symptoms gave rise to a significant lowering in the risk of any new onset of CVD (hazard ratio, HR = 0.88, 95% CI 0.86 – 0.89). This was true for coronary heart disease (HR = 0.89), stroke (HR = 0.88) and all-cause mortality (HR = 0.81). This reduction in CVD risk was higher in those aged below 60.

The authors suggested that management of depression with psychological therapies might therefore reduce the risk of subsequent CVD.

El Baou C et al. Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England. Eur Heart J 2023

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