Depression deter mental catabolic effect over the time, symptomatically affects quality of life which leads to worse health outcomes that linked to higher mortality and morbidity rates with huge impact on public health. Chronic conditions like Cardio Vascular Diseases (CVDs) deteriorates patient health with cognitive impairment that progresses to somatic dysfunction, which can exacerbate to the occurrence and development of depression with the increased risk of inducing Chronic Diseases. Depression are often neglected, overlooked and remains unrecognized and undertreated in the patient, especially in CVDs patient are considered as normal that instances to poor prognosis.  The association of depression and CVDs are not incidental, but the lack of diagnosis for the coexistence of these co-morbid condition and poor treatment hindrance the disease outcome. Depression emerges an alarming cardio vascular risk factor which is associated with higher cost of care for the patient as well as burden to the healthcare system. Prior detection and identification with rational intervention of depression at CVDs will help to change the scenario by improving the standard of health and overall quality of life of patient. Here, in this study we assess the prevalence of depression at cardio vascular disease patient in Nilgiris population.

Depression is a common disorder in Cardio-vascular patients with a prevalence of twenty percent (20%) to forty five percent (45%), which is much more frequent than in the general population. Depressive symptoms are often overlooked in cardiac patients and their manifestation, especially after MI, is considered normal. Almost every life-threatening condition, including MI, stimulates the hypothalamus to secrete the corticotropic-releasing hormone, which stimulates the HPA axis. The two-way connection between depression and heart disease, which share the pathophysiological mechanism of origin, affects the prognosis of post-infarction recovery of depressed patients due to the impact of depression on the HPA axis activation, endothelial dysfunction, platelet reactivation and enhanced inflammatory response. An observational, cross-sectional study was conducted at secondary care government hospitals located at the Nilgiris district on different cardiovascular disease patients using HAM-D questionnaires for the assessment of depression. In this study, the level of depression in cardiovascular disease patients were assessed associating with patient variability in relation to age, gender, education, food habits, social habits, duration of disease and blood pressure values. There was a significant increase in depression score with the increase in blood pressure level. The patients were found to be having depression even though they were on cardiovascular treatment after they were being diagnosed with cardiovascular disease. With the treatment of cardiovascular disease conditions, the assessment for depression should be done and if required, depending on the level of depression, counselling and/with psychotherapy (eg. Cognitive behavioural therapy) may be recommended to avoid cardiac morbidity and mortality.