What doctors should look for after cardiac arrest: Study

Care after cardiac arrest should also include mental health support, especially for women, a new study finds.

Five years after an out-of-hospital cardiac arrest (OHCA) — when the heart stops suddenly — women are more likely than men to be prescribed medication to treat anxiety or depression, according to a report published Monday in the journal Medical News. Circulation: Cardiovascular Quality and Outcomes.

“We recommend monitoring the social and mental health of people who survive OHCA not just immediately after the accident but over the long term,” Dr. Robin Smits, lead author of the study, said in an email.

“This seems especially relevant for women, but men may also benefit.”

The researchers analyzed data from 259 women and 996 men in the Netherlands who survived at least 30 days after an out-of-hospital cardiac arrest between 2009 and 2015. According to the study, the team compared data on the patients' socioeconomic status and mental health with that of the general population.

Smits, a postdoctoral researcher at the Amsterdam University Medical Center in the Netherlands, said more women were also taking medication for anxiety and depression after cardiac arrest than women in the general population.

“Further research may shed light on what interventions physicians need to make to help patients recover after OHCA,” Smits said.

Researchers are learning more and more about how mental health and heart health are closely related, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, who was not involved in the study.

One in five people hospitalized for a heart attack (blockage of blood flow to the heart) or chest pain suffers from severe depression, about four times the rate in the general population, reports the American Heart Association. American Heart AssociationPrevious studies have shown that one in three people who have had a stroke will develop depression, as will half of those who have had heart bypass surgery.

“Mental health and stress make heart attacks worse and more frequent, and we know heart attacks make mental health worse,” he said.

This is just the beginning of your quest for mental and heart health

While the new study explores an important topic, it's only the beginning, Freeman said.

The authors considered factors that could skew the results, and there are many, he said.

For example, the study only looked at how many people were prescribed the medication, but that doesn't necessarily mean that only those who were prescribed it were experiencing anxiety or depression, Smits said.

“These findings may in part reflect men seeking mental health care less frequently and receiving evaluations and medication less frequently,” she said in an email. “Furthermore, the data do not fully reflect their actual experiences, including forced changes in job responsibilities and the impact on other areas of their lives.”

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

Check in on your emotional wellbeing

Freeman said the biggest takeaway from this latest study is for loved ones and medical personnel to check in on someone who has experienced a cardiac arrest.

“Are there strategies we can take more proactively to help people who have had a cardiac arrest bounce back and realize that, in many cases, they are incredible survivors?” he said.

Even if your doctor isn't a psychiatrist, it's important to keep an open line of communication about your health, so they may be able to refer you to a mental health specialist, he said.

Fortunately, there are plenty of strategies to improve your mental health, and past studies have shown that cognitive behavioral therapy, regular exercise, and adequate sleep are effective tools for managing your emotional health.

“As physicians, how can we help patients avoid or treat these issues as they arise or before they occur?” Freeman said.