Thread by @hyderabaddoctor

Effective treatment of #depression through psychological therapy is associated with lower risk of #stroke and #heartattack
1. 6,36,955 people with depression were treated with psychotherapy and were followed up for a median of 3.1 years.
#MedTwitter

2. Reliable improvement from depression was associated with a 12% decrease in incident risk of cardiovascular disease (CVD) at any given time, with similar results observed for coronary heart disease (CHD), stroke, and all-cause mortality (death).

3. Benefit was maximum in those aged 45-60 years. For this group, the improvement in depression was associated with a 15% decrease in cardiovascular diseases. In patients over 60 years of age, there was only a 6% decrease.

4. The reduction in all cause death rate was also highest in 45-60 year age group. Their mortality risk underwent a 22% reduction. This reduction was only 15% in the adults over 60.

5. Lesser improvement in people aged 60 or more could be related to the fact that improvement in depression may not lead to a significant increase in physical activity (as compared to younger people). Moreover, they could have additional risk factors such as high BP or diabetes.

6. The exact cause of this association is not known. Possible reasons:
*Improvement in depression can encourage people to engage in greater physical activity.
*Depression leads to greater inflammation including in blood vessel walls, which can explain higher risk of CVDs.

7. Take home message:
*Management of depression through psychological interventions may be associated with reduced risk of CVD.
*More research is needed to understand the causality of these associations.
doi.org/10.1093/eurhea…