Depression increases the risk of dying from heart disease

The research team from London medical schools say more work is needed to find out how the symptoms increase the risk of a heart attack.

Professor Andy Haines, who led the study, which is published in Heart journal, said he also wanted to examine the effect of psychological interventions, such as cognitive behavioural therapy.

He told BBC News Online: "In general terms men often won't tend to go to the doctor with psychological symptoms. And if they are not going to the doctor, they don't see it as a problem."

He said the study had confirmed obsessive tendencies and symptoms of anxiety were an increased risk factor, but that it was not yet known why.

No heart disease history

The men in the study, aged between 40 and 64, were recruited from three occupational groups in north-west London, and were not under the care of a doctor.

They had no heart disease problems when they joined the study, after being recruited via letters to their companies.

They answered a psychological questionnaire, which allocated points to various areas of mental health, allowing researchers to measure the scale of psychological problems.

Each one point increase in the scores for obsessive habits and anxiety symptoms increased the relative risk of heart attack by 8%.

The men who died had higher overall scores. A 10-point increase was linked to a 28% higher risk of a fatal attack.

Phobias also increased the risk of an attack by 7% per point, but only for those men who died within the first 10 years of the study.

Depressed heart attack patients risk another attack

Information on deaths among the group was taken from the NHS central register.

The researchers studied the health records of the 127 who died, and their responses to the questionnaire.

The study's findings take into account risk factors such as smoking, age and social class.

Depression link

The Dutch study looked at 2,900 people between 55 and 85 years old over four and a half years.

It found that among those patients who did not have heart disease, but who did have major depression, deaths related to the heart disease almost quadrupled.

Death rates tripled in those who already had heart disease when the study began, and who developed depression.

The British Heart Foundation (BHF) has said a patient who is seriously depressed after a heart attack is over three times more likely to have a second attack than a patient who is not depressed.

It added that working in a stressful job with little control over work increases the risk of coronary heart disease by more than 50% compared to having a job with more control of variety and pace of work.

'Social crutches'

Melanie Raddon, a cardiac nurse for the BHF, said it had also identified a possible link between psychological factors like anger, depression and anxiety and coronary heart disease, though again it was not known why.

But she added: "This research has accounted for the effects of some risk factors such as smoking.

"However it is clear that anxiety can lead to a less healthy lifestyle and reliance on 'social crutches' such as comfort food and alcohol.

"While these secondary factors are important, further research is necessary to establish what direct affects, if any, our state of mind has on our hearts."