Women: Understanding the Links Between Heart Disease and Depression

You may think that since heart disease usually develops in women in their 50s and beyond, millennials don’t need to worry right now. That’s wrong, says Roy Ziegelstein, M.D. , professor and cardiologist at Johns Hopkins Medicine. “There is a long time between the earliest problems in blood vessels and the development of symptoms of heart disease,” Ziegelstein says. “The process often starts in your 30s, so to avoid problems later in life, it’s important to follow recommended guidelines now”.

Best practices for a healthy heart that you can begin today are:

  • Maintain a healthy weight.
  • Eat healthy foods that help you control blood sugar and cholesterol.
  • Get and stay active.
  • Manage your stress with things such as meditation, yoga, tai chi, relaxation therapy and exercise.
  • Avoid being socially isolated; relax with friends and family.
  • Stop smoking.

The Link Between Depression and Heart Disease

Most importantly, if you have symptoms of depression you may have a higher risk for developing heart disease later in life. For older women who have heart disease, the chances that they will have another heart attack increase when they’re also depressed. Why is that?


Ziegelstein explains that women suffering from depression generally have a harder time following the recommended guidelines for heart health. They also tend to withdraw from their support network, which includes family, friends and physicians. For some with depression, this can also mean engaging in higher risk behaviors such as smoking and overindulging in alcohol. Depressed women with heart disease may be less likely to go for follow-up care or take the medications recommended by their primary care doctor or cardiologist, thereby increasing the risks of another episode.


Research shows a possible connection between depression and heart disease that is related to a link between depression and inflammation and a link between inflammation and atherosclerosis — or what some call “hardening of the arteries.” In addition, there is a link between inflammation and the formation of blood clots.

“Our research shows increased complications in patients with both depression and heart disease,” says Marlene Williams, M.D. , associate professor and cardiologist at Johns Hopkins Medicine. “We are examining how inflammation activates blood platelets, and may contribute to increased blood clots in both men and women with heart disease and varying levels of depression.”

Advice for Caregivers

Many of us care for an elderly parent or family member. What can we do as caregivers to help those who are most at risk for developing heart disease?

Ziegelstein says that when seniors — especially women — live alone, it is often a “double-whammy” for heart disease. Not only are people who live alone often less likely to follow heart healthy guidelines like staying active and eating well, they’re also less likely to go to the doctor promptly if they experience symptoms or “warning signs” of a heart attack. “Time is muscle,” Ziegelstein adds. “The longer you wait to restore the blood flow to the part of the heart that is being deprived of blood and oxygen, the more damage will be done.” He stressed the need for caregivers to check in on senior parents and other family members, and be available as a quick go-to if your loved one thinks they may be experiencing symptoms.

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