The medical world has been waiting eagerly for the results of The REACH (Resource Utilization Among Congestive Heart failure patients) study, that examined many features of atherosclerotic disease in nearly 70,000 patients 45 years of age or older in 44 developed countries around the world. The report is expected to be useful for doctors with patients at risk for heart disease. The research report was presented at the recent heart meeting in Atlanta. The study shows that the risk of cardiovascular events like heart attack, stroke,

And death increase steeply when atherosclerosis is present in vascular systems throughout the body.

Now the question is who is at risk? For study participants with three risk factors but with no known vascular disease, the risk of a major cardiovascular event at the end of one year of follow-up after entering the study was 1.5 percent which is about half the risk for those with known coronary disease. But there is a hike in the risk of a cardiovascular event by 50% in patients with cerebrovascular disease or peripheral artery disease alone, when it is compared with patients suffering only had coronary disease.

The study shows that the risk of a cardiovascular event is more than doubled when patients with coronary disease were compared to those with the combination of coronary, cerebrovascular, and peripheral artery disease. These findings of this study are really shocking as most of the patients on whom the study was done were already being treated with statins, antihypertensive medications, and aspirin.

The study reveals a widespread distribution of atherosclerosis in the body. One among the authors of the study journal states that the doctors should now view patients not as walking coronaries or walking peripheral arteries, but really patients with global atherothrombosis. It also conveys a message to the patients that they should make sure their doctors look beyond the heart and the traditional risk factors to determine cardiovascular risk.

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The recent health study reveal that the negative changes in health behaviours are a major reason for the increased risk of cardiovascular events such as heart attack among heart patients with depression. The study was conducted by U.S. researchers on 1,017 outpatients with stable coronary heart disease for an average of 4.8 years.
Depression has been identified as a risk factor for cardiovascular disease in healthy people for past long years and for recurrent events in patients with cardiovascular disease. But the association between the both was not clear.

Dr. Mary A. Whooley, of the VA Medical Centre in San Francisco, under whom the study was conducted, along with her colleagues used a questionnaire to measure the heart disease patients’ symptoms of depression. Various models were used to evaluate the connection between subsequent cardiovascular events including heart failure, heart attack, stroke, depression, disease severity at the start of the study, and biological and behavioural factors.

The study conducted by the American researchers revealed that patients with depression had a 50 percent greater risk of cardiovascular events. When the doctors adjusted for other existing conditions and cardiac disease severity, it was found that depression is associated with a 31 percent increased risk of cardiovascular events.
Dr. Whooley and her colleagues further went ahead with their research on certain health behaviours, including physical inactivity, and found there no longer exist a significant association between depression and cardiovascular events.

The study concludes that heart patients with depression are less likely to follow dietary, exercise and medication recommendations; where as poor health behaviours can cause cardiovascular events.  The study is published in the Nov. 26 issue of the Journal of the American Medical Association.

“Dr. Whooley says in her book that understanding the way depression causes cardiovascular events is necessary for developing interventions to decrease the excess cardiovascular morbidity and mortality related with depression.

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