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Study finds association between depression, PAD


Depression was linked with an increased risk of peripheral artery disease in a study of more than 1,000 men and women with heart disease.

Marlene Grenon, MD, CM, a vascular surgeon at the San Francisco VA Medical Center and an assistant professor of surgery at the University of California, San Francisco, led an analysis of data from 1,024 participants in the Heart and Soul Study, a prospective study of men and women with coronary artery disease who were followed for an average of approximately seven years.

“We discovered that there was an association between depression and PAD at baseline, and also found that the patients who were depressed at the beginning of the study had a higher likelihood of developing PAD during follow-up at seven years,” Grenon said in a news release.

“These findings add to the growing body of research showing the importance of depression in both the development and progression of PAD,” said senior author Beth Cohen, MD, MAS, a physician at SFVAMC and assistant professor of medicine at UCSF. “This also emphasizes the need for medical providers to be attentive to the mental health of their patients who have developed, or who are at risk for, PAD.”

The authors found that some of the risk for PAD was partly explained by modifiable risk factors such as smoking and reduced physical activity.

“We still don’t know which comes first,” Grenon said. “Is it that patients with PAD become depressed because their mobility is impaired, or that people who are depressed engage in unhealthy behaviors such as smoking and lack of exercise, and are thus more at risk of developing PAD? Or might it be a vicious cycle, where one leads to the other?” Further research is needed to tease out cause and effect, she said.

Whatever the initial cause, lifestyle modifications such as being more physically active, eating better, quitting smoking and managing stress more effectively might reduce the risk for the association, as well as potentially address symptoms of both PAD and depression, the researchers said.

“As providers, we can help patients recognize the connections between mental and physical health,” Cohen said. “This may help reduce the stigma of mental health diagnosis and encourage patients to seek treatment for problems such as depression.”

The study appeared July 25 on the website of the Journal of the American Heart Association. To read it, visit


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