ATLANTA (CBS Atlanta) – Stress and depression can be dangerous for people with heart problems, a new study finds.

According to LiveScience, researchers found that people who had high levels of both stress and depression were 48 percent more likely to die or have a heart attack compared with people who had low levels of stress and depression.

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The researchers said in their study that the combination of stress and severe depression along with heart problems can create a “psychosocial perfect storm.”

“The increase in risk accompanying high stress and high depressive symptoms was robust and consistent across demographics, medical history, medication use, and health risk behaviors,” Carmela Alcantara, an associate research scientist at Columbia University Medical Center in New York City, and lead author on the study, said in a statement obtained by LiveScience.

Almost 5,000 people with coronary heart disease participated in the study between 2003 and 2007. Each participant was at least 45 years old and had to answer questionnaires on their symptoms of depression and stress.

The researchers found that 274 people, or about 6 percent, had both high stress and high depression. After a six-year follow up, 1,337 people had either died or suffered a heart attack.

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The researchers noted that the “high vulnerability period” during which people with intense stress and depression were at increased risk of dying or having a heart attack lasted about two and a half years, after that, the increase risk disappeared.

They also found that people who had either high stress or high depression symptoms, but not both, did not have an increased risk of death or heart attack

The Centers for Disease Control and Prevention report that more than 1 out of 20 Americans 12 years of age and older have suffered from depression.

Depression is characterized by depressed or sad mood, diminished interest in activities which used to be pleasurable, weight gain or loss, psychomotor agitation or retardation, fatigue, inappropriate guilty, difficulties concentrating, as well as recurrent thoughts of death. The American Psychiatric Association say that five or more of those symptoms must be present for at least two weeks before being diagnosed with the disorder.

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The study was published in the journal Circulation: Cardiovascular Quality and Outcomes.