About 1 in 5 people suffering from heart failure become clinically depressed, and four factors seem to increase the risk, researchers reports.

“Depressive symptoms in patients with heart failure are strongly associated with a decline in health status and an increase in the risk of hospitalization and death,” Dr. Edward P. Havranek, of Denver Health Medical Center, in Colorado, and colleagues note.

They examined social, demographic and clinical factors associated with the onset of depression in 245 heart failure patients who were not depressed to begin with.

Fifty-two (21 percent) of the study participants developed symptoms of depression after 1 year, the team reports in the Journal of the American College of Cardiology.

Compared with those without depressive symptoms, depressed patients were significantly more likely to live alone, to find medical care a severe economic burden, to have a history of alcohol abuse, and to have significantly worse heart failure scores.

Only 8 percent of patients with none of these four risk factors developed significant symptoms of depression. Among those with one risk factor, 15 percent became depressed. For those with two or three risk factors, the rate increased to 36 percent and 69 percent, respectively. None of the patients had all four risk factors.

“Future studies are needed to evaluate whether interventions aimed at the prevention of depression and/or the treatment of depression in those who screen positive will improve outcomes,” Havranek and his colleagues write.

In the meantime, they urge doctors to be mindful of “the high incidence of depressive symptoms and the risk factors for development of depression in patients with heart failure.”

SOURCE: Journal of the American College of Cardiology, December 21, 2004.