According to a new study conducted by French researchers, people who have both depressions and heart disease are much more likely to die than those with just one or neither of the conditions.

The study, published in Heart journal, tracked the mental and physical health of 6,000 middle-aged people over five years. Around one in seven of the 6,000 (14.9%) scored highly on a depressive symptom scale. And one in five (20%) of those with established heart disease were depressed.

During the study period, 170 people died. Heart attacks and strokes accounted for 47 of these deaths.

The study showed that people with both heart disease and depression were almost five times more likely to die than those who were both mentally and physically healthy.

The author also added that, “After taking account of age and sex, and other relevant influential factors, the combination of depression and heart disease tripled the risk of death from all causes and quadrupled the risk of dying from a heart attack or a stroke.”

The research results were published online in the medical journal Heart.