Women more likely to experience anxiety after cardiac arrest, study finds

Care after cardiac arrest should include mental health support – especially for women, new research suggests.

In the five years following an out-of-hospital cardiac arrest (OHCA), in which the heart suddenly stops beating, women were more likely than men to receive medication to treat anxiety or depression, according to a report published Monday (8) in the journal Circulation: Cardiovascular Quality and Outcomes.

“We recommend monitoring social and mental well-being in individuals who have survived an OHCA, not only directly after the event but also in the long term,” says the study’s first author, Robin Smits, in an email. “This seems particularly relevant for women, but will likely benefit men as well.”

Researchers analyzed data from 259 women and 996 men in the Netherlands who survived at least 30 days after cardiac arrest that occurred outside a hospital between 2009 and 2015. The team compared data on the patients’ socioeconomic status and mental health with that of the general population, according to the study.

The number of women taking medication for anxiety or depression after cardiac arrest was also higher than in women in the general population, says Smits, a postdoctoral researcher at Amsterdam University Medical Center in the Netherlands.

“Further research may shed light on what interventions are needed for clinicians to help people thrive after OHCA,” Smits says.

Researchers are increasingly learning about how mental health and heart health are closely linked, said Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver. He was not involved in the research.

One in five people hospitalized for a heart attack (a blockage of blood flow to the heart) or chest pain develops major depression — about four times the rate in the general population, according to the American Heart Association. One in three stroke survivors gets depressedlike this up to half of those who undergo coronary artery bypass graft surgery, according to previous studies.

“Mental health and stress worsen and make cardiac events more frequent, and we know that cardiac events worsen mental health,” he said.

Just the beginning of diving into mental and heart health

This new study investigates an important topic, but it’s just the beginning, Freeman says. While the authors considered factors that could skew the results, there are many, he says.

For example, the research could only look at the number of people who were prescribed medication – but that doesn’t necessarily mean they were the only people experiencing anxiety or depression, Smits said.

“The results may also reflect, in part, that men may seek less mental health care and are perhaps less frequently evaluated and prescribed medication,” he said in an email. “In addition, the data do not fully reflect lived experience, such as forced changes in work responsibilities or effects on other areas of life.”

But this study highlights an important concept: that men and women often experience the world differently, and health care providers need to be aware of this to provide the best care for everyone, Freeman said.

Monitoring emotional well-being

The biggest takeaway from this latest research is for loved ones and health care providers to follow up with people who have had cardiac arrest, according to Freeman.

“Is there a strategy that we should be taking more proactively after cardiac arrest to make sure that they’re back on track, that they understand that they are incredible survivors in many cases?” she says. Even if the doctor you’re seeing isn’t a psychiatrist, it’s important to keep an open line of communication about your well-being — and then you may be referred to a mental health professional, she adds.

Fortunately, there are many strategies for improving mental health. Previous studies have shown that cognitive behavioral therapy, regular exercise, and adequate sleep are effective tools for managing emotional well-being.

“As a physician, how do we help people prevent or treat these problems as they arise? Or even before they arise?” says Freeman.

If you or someone you know is struggling with mental health, help is available. The Center for the Valorization of Life (CVV) is available 24 hours a day at 188. You can also contact us by email at [email protected].

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