Baptist Health Louisville cardiologist says heart disease, depression linked

February 24, 2022

Heart disease can cause or worsen depression.

Steven J. Heatherly, MDLOUISVILLE, Ky. (Feb. 24, 2022) - Depression and heart attack have a two-way relationship: patients with heart disease are at risk of becoming depressed (especially after a heart attack), and depression may increase the chances of developing heart disease.

“We have many years of research showing that depression is a risk factor for the development of coronary artery disease,” said Steven J. Heatherly, MD, Ph.D., FACC, System Medical Director of Heart Failure & Pulmonary Hypertension, Baptist Health Louisville. “And, if you have coronary artery disease and depression, you are likely to have worse coronary disease and symptoms. Depression and heart disease are a two-way street.”

In fact, heart disease can cause or worsen depression.

“Those patients who have depressive symptoms have a worse prognosis if they have heart disease. In fact, depressed patients are twice as likely to die if they develop depression after being diagnosed with heart disease,” said Dr. Heatherly. “The strongest predictor of death in heart disease is depression.”

It’s these new lifestyle limits which may cause persons diagnosed with heart disease to become depressed (or more depressed) as they cope with a growing sense of helplessness as they wrestle with:

  • Uncertainty about the future.
  • Lack of confidence in their role as an employee, spouse, parent, friend, etc.
  • Guilt and regret about past lifestyle choices that may have affected their health.
  • Worries about dying and how their absence would affect their family

Depression can cause heart disease; hinder recovery

Not only can heart disease cause or worsen depression, but the opposite is true as well. For example, the stress associated with unmanaged depression can lead to high blood pressure and also increase the risk of developing blood clots and having a heart attack. Changes in the nervous system can cause abnormal heart rhythms.

In those recovering from heart attack or heart surgery, depression can cause fatigue and intensify pain – both of which reduce the likelihood that they’ll stick to a rehabilitation plan.

“Depression and depressive symptoms can lead to a general lack of interest in life. This is the exact opposite of what we need our heart patients to have,” added Dr. Heatherly. “Our heart patients with depression are more likely to not follow a healthy lifestyle. They are less likely to exercise or take their medications.”

Two-pronged approach

While the link between heart disease and depression is complicated, what’s clear is that it’s best for those suffering from either condition to address both. The good news is that improvements you make in your heart health are likely to have a corresponding effect on your depression, and vice versa.

“Having our depressed cardiac patients engage in moderate physical activity is helpful. We have a lot of psychological research showing benefits to exercise,” said Dr. Heatherly. “Not only is exercise good for your heart, it is good for your mind. It can help you gain confidence and cope in a healthy way. It can even lower depressive symptoms.”

You can actually leverage the link between your heart disease and your depression to make positive changes in your overall health. Make a plan to improve your heart health and your mental health today.

Learn more about your heart health by taking our free Heart Health Assessment at For help with depression or more about Behavioral Health Services, call the 24-hour Access Center at 502.896.7105 or toll free at 1.800.478.1105.