People suffering from some form of heart disease appear to be at a higher risk of depression as well and, consequently, they should be screened for the condition, according to the latest guidelines of the American Heart Association released on Monday.

The guidelines are based on a series of analyses made by the University of California, San Francisco researchers who reviewed dozens of studies and found that depression is three times more common among people who have had a heart attack compared to the general population, Judith Lichtman of Yale University School of Medicine, who helped write the new guidelines, said. In addition to this, depression is equally existent in people who were hospitalized for such conditions as unstable angina, angioplasty, bypass surgery, or valve surgery.

Research has shown that 15 percent to 20 percent of patients hospitalized with a heart attack have symptoms of major depression. People suffering from heart disease who are not hospitalized show depression rates of about 9.3 percent, compared with 4.8 percent of healthy people, the AHA says.

Heart disease is the top cause of death in the United States with more than 80 million people suffering some form of it. This makes the new guidelines the more important, as they could save thousands of lives.

The bad news is that depression can worsen patients’ outcomes making them more vulnerable to continuing or recurrent heart problems. This is the first time the AHA calls for measures when it comes to cardiac patients and depression, Erika Froelicher, RN, MPH, PHD, professor of nursing and epidemiology and statistics at the University of California, San Francisco and co-chair of the writing group that created the recommendations, said. Dr. Lichtman also supports the idea.

“Because there has been no routine screening for depression in heart patients, we think there is a large group of people who could benefit from appropriate treatment,” she said.

Therefore, anyone from cardiologists to nurses to primary care doctors can and should be involved in determining whether a patient is depressed.

Cardiac patients should be asked two key questions: “Have you recently felt little or pleasure in doing things?” and “Are you feeling down, depressed or hopeless?” If patients answer yes to both of them, they should immediately be evaluated further with a second questionnaire of nine items.

Those patients scoring high on the second questionnaire must be referred to a professional qualified in the diagnosis and management of depression. The treatment of depression might include antidepressant drugs, behavior or talk therapy and physical activity.

Sometimes, these patients don’t need medication. A healthy lifestyle including healthy food and physical activity and therapeutic meetings sometimes help. But for those who really need medications, the AHA recommends antidepressants Zoloft and Celexa, as research has shown they are generally safe for cardiac patients.

Moreover, cardiac patients suffering from depression should also be screened for other psychiatric disorders, such as anxiety, which is known to have repercussions on the heart.

The new AHA guidelines are available in the Sept. 29 issue of the online issue of the journal Circulation.