The emotional side of heart failure: Why do heart failure patients become depressed?

11/07/2019 / By Melissa Smith

Heart failure leads to many complications, especially in the cardiovascular system, but research suggests it could also lead to mental health problems. Heart failure patients often suffer from depression and cognitive impairment, and researchers from Canada have uncovered why these problems occur. Their findings were published in the journal Scientific Reports.

Researchers from the University of Guelph in Ontario and the University of Toronto observed two groups of mice and compared them with each other: a group of normal mice and another group carrying a mutation in their circadian mechanism or “body clock.” The research team found that the mutation influenced the structure of neurons in brain areas responsible for cognition and mood. They also saw differences in clock regulation of blood vessels in the brains of mice carrying the mutation.

The researchers also induced heart failure in the mice. They used microarray profiling to identify key genes in the brain that were altered in neural growth, stress, and metabolism pathways. The results showed that the circadian mechanism affects the neural effects of heart failure. The researchers said that understanding how the circadian mechanism works in the brain may provide insight into the development of new strategies for improving the quality of life of patients.

Individuals recovering from heart attack typically experience disturbed circadian rhythms due to light, noise, and interactions with hospital staff at night. Based on the findings, the researchers suggest that maintaining circadian rhythms especially for patients with heart disease could result in better outcomes. Furthermore, they suggest avoiding shift work for people with underlying heart conditions or sleep disorders, reducing light at night, or avoiding social jet lag to help reduce neurobiological impairments. (Related: Heart failure patients require restorative rest; treating sleep disorders provides cardiovascular benefits.)

“If we’re not yet able to cure heart failure, we should at least be focusing on how we can improve quality of life for patients,” said Tami Martino, a professor at the University of Guelph and one of the researchers of the study.

This study is the first to uncover how body clock regulates cognition and mood in mice and how pertinent brain areas are impaired by heart failure.

Lifestyle changes for people with heart failure

Making healthy lifestyle changes can result in huge improvements in the lives of people with heart failure. These can help reduce symptoms, slow the disease’s progression, and improve the patients’ everyday life. People with mild to moderate heart failure often experience nearly normal lives as a result. Here are some important lifestyle changes that can improve the lives of people with heart failure:

Quitting smoking – Every puff of nicotine-filled smoke from cigarettes temporarily speeds up heart rate and increases blood pressure. In addition, smoking results in clumping or stickiness in the blood vessels feeding the heart. People with heart failure who have quit smoking are more likely to have their symptoms improve.
Maintaining a healthy weight or losing excess weight – Sudden weight gain (or loss) can be a sign of developing heart failure or progressing heart failure. It’s best to monitor your weight every morning, preferably before breakfast and after urinating.
Monitoring your daily fluid intake – People with heart failure tend to retain fluid in their bodies. Keep track of your fluid intake to avoid water retention.
Following a heart-healthy diet – Eating plenty of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts, legumes, and healthy fats not only benefits the heart but also your overall health. More importantly, limit your intake of saturated fat, cholesterol, red meat, trans fat, sweets, and sugar-sweetened beverages.
Managing stress – Too much stress can take a toll on your heart and mental health. Take 15 to 20 minutes a day to sit quietly, breathe deeply, and think of a peaceful or relaxing scene. You may also try mind-body relaxation techniques like yoga.