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During American Heart Month, we’ve been highlighting aspects of cardiovascular (heart) disease to help you understand your own heart health and what you can do to be as kind to that precious organ as you can possibly be.

And, while you may tend to associate heart disease with more physical actions, such as a smoking, poor diet and a lack of exercise, heart attacks, strokes and other cardiovascular problems can also be very much affected by your thoughts, attitudes and emotions. They can not only accelerate the onset of heart disease, but also mess with your ability to take those positive steps to improve your heart health.

A combination of stress and heavy depression can significantly increase heart patient’s risk of death or heart attack, according to research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. A study by the Columbia University Medical Center for Behavioral Cardiovascular Health in New York also found high stress and deep depression among heart patients may up the risk of death or heart attack by 48 percent. Experts believe behavioral interventions may be needed to help heart patients manage both stress and depression. The American Psychological Association (APA) says there are some things you can do for yourself in this regard:

Practice prevention

A healthy lifestyle can go a long way toward reducing the risk of heart disease or managing a diagnosed condition, even if you face a higher risk due to uncontrollable factors such as age, sex or family history. But making changes in your daily life is not always easy and takes personal discipline. You may sense a loss of control over your life in eating differently, making time for exercise and taking regular medication.

Coping skills

How you handle stress influences how your cardiovascular system responds. Studies reveal that if stress makes you angry or irritable, you’re more likely to have heart disease. In fact, the way you respond to stress may be as great a risk factor for heart problems as smoking, high blood pressure and high cholesterol.

Avoid the downward spiral

Depression is a persistent feeling of sadness and despair that can isolate you from the rest of the world. In its severest form, clinical depression not only increases the risk of heart disease but can worsen an existing condition.

Research shows that while only about 20 percent of us experience an episode of depression in our lifetimes, the figure climbs to 50 percent among people with heart disease. Men and women diagnosed with clinical depression are more than twice as likely to develop coronary artery disease, while heart patients are three times as likely to be more depressed at any given time than the population as a whole.

Bottom line – If left untreated, clinical depression can put you at substantially greater risk of suffering a heart attack or stroke and complicates the aftermath of a heart attackstroke, or invasive procedure such as open-heart surgery.

What’s more, your heart health can also affect your mental and emotional well being later in life. There is a connection between vascular health and dementia. Next to Alzheimer’s, vascular dementia is considered the second leading cause of problems with reasoning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain.

While there are no treatments to prevent or cure dementia at present, a Boston University School of Medicine study published in the New England Journal of Medicine suggests that rates for dementia have been falling in recent decades – and that increased emphasis on heart heat in that time period may be the reason. But the study also suggests that cautious optimism should not become complacency.

  • Identify the sources of stress in your life and look for ways to reduce and manage them.
  • Avoid trying to fix every problem at once. Focus instead on changing one existing habit.
  • Don’t ignore the symptoms of depression if lasting more than two weeks.

If you feel overwhelmed by the challenges of managing the behaviors associated with heart disease, you might want to consult a qualified psychologist that will work with your doctor to devise a suitable treatment program.