Depression, Money Woes Higher in Heart Patients With Job Loss

Depression, Money Woes Higher in Heart Patients With Job Loss

Folks who can't get back to work after a heart attack have a greater risk of depression and financial hardship than those who return to their jobs, a new study finds.

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There were more than 9,000 patients in the study, and about half were working before their heart attack. The researchers reported that 90 percent of the heart patients who were working returned to work within a year after the attack. Seven percent couldn't get back to work within the first year and 3 percent were working but less than before their heart attack.

Of those who didn't go back to work fully, about 27 percent reported depression, compared to 17 percent of those working. Patients not working fully also reported having worse health, and 41 percent said they had moderate to extreme financial hardship when it came to paying for their medications, versus 28 percent of those back at work.

"One of the things that is most important to patients is the ability to resume work after a health shock like a heart attack," said the study's lead author, Dr. Haider Warraich. He's a fellow in cardiovascular disease at Duke University Medical Center in Durham, N.C.

"Heart attack is such a huge shock, and many people look at life differently after a heart attack. On top of that, if you associate wellness with being productive, and you're unable to work, that would compound the effect of the heart attack. And, then if you add in the financial implications of not being able to work, that makes a bad situation worse," he added.

Warraich said that overall, the study's results were encouraging, but there's still room for improvement.

"We need to focus on these patients unable to resume work," he said.

People who had excess bleeding and those who needed to be rehospitalized were less likely to return to work than people who didn't have those complications, according to Warraich. And that gives doctors two outcomes to try to focus on, he said.

It's not clear from this study what interventions might help, but Warraich said it's possible people who can't get back to work may need more cardiac rehabilitation or more social services.

The study included more than 9,300 patients who had participated in another study that tested how well a drug worked for people who had a heart attack. The initial study group had more than 12,300 heart attack patients, but about 3,000 were excluded because they hadn't provided work information one year after their heart attack.

Their average age was 61 and 27 percent were women. They were recruited from 233 U.S. hospitals.

Before their heart attacks about 4,700 people were working. Nearly 4,600 were not working, but 3,400 of those said they were retired.

Dr. James Catanese, chief of the division of cardiology at Northern Westchester Hospital in Mount Kisco, N.Y., said the research definitely provides "food for thought. We need to know more about who gets back to work and who doesn't. We also need studies that look at this issue so we know how best to intervene." He was not involved with the research.

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However, Catanese also took issue with some of the study's methodology.

"The original study had 12,000 people, and they only have data on 9,000 people. You can't say only 10 percent didn't get back to work when you left out 25 percent of the group because of a lack of data," Catanese explained.

The study was published June 12 in the journal Circulation: Cardiovascular Quality and Outcomes.

More information

To learn more about the link between heart disease and depression, visit the American Heart Association.


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