Past studies have found that patients who are depressed or who have little social support are at greater risk for heart disease. A recent study failed to show that treating depression and providing social support improved lifespan following a heart attack.  The Enhancing Recovery in Coronary Heart Disease Patients Study is the first major study to evaluate the effects of treating depression and low social support in patients who have had a heart attack. Up to 25 percent of heart disease patients have either depression or low social support after a heart attack. Past studies have shown that heart disease patients who have either one of these risk factors have a 3 to 4 times higher risk of death.

The NIH-funded study adds complexity to our understanding of the relationship between psychological and physiological factors that influence heart disease. “This study is an important first step in our quest to understand how to reduce heart disease risk by treating depression and social isolation. Although we did not see the hoped-for reduction in deaths and heart attacks, it is encouraging that the treated patients felt better and experienced improved social relationships,” said NIH/National Heart, Lung, and Blood Institute Director Claude Lenfant, M.D. “We still know from other studies that depression and low social support in heart disease patients are risk factors for mortality. That is why it is important to analyze these results and to conduct further research so we can reduce deaths and heart attacks.”

The scientists who conducted the study suggested that the lack of effect on heart disease deaths and heart attacks may be because both groups of patients studied had less depression and increased social support after participating in the trial. One group received 6 months of psychological counseling. This group showed the greatest improvement in psychosocial measures. The other group received “usual medical care,” but they also showed improvement in depression and social support (to a lesser degree). According to the researchers, the difference between groups may not have been large enough to have an impact on deaths and number of heart attacks.

It seems likely that depression and low social support can take a long time to influence heart disease. Persons whose depression influenced their second heart attacks may have been depressed for years. A six month intervention may not have been powerful enough to counteract this long-term condition. Six months of support may certainly help someone's life, but it may not be enough to lengthen their life.