Depression associated with increased risk for heart disease in men and women; depressed men also have increased risk of death

Both men and women with depression have an increased risk for coronary heart disease (CHD); however, men are at an increased risk of CHD mortality while women are not, according to an article in the May 8 issue of the American Medical Association's Archives of Internal Medicine, a member of the JAMA family of journals.

To investigate the differential effect depression may have on CHD incidence and death in men and women, the researchers analyzed data from 5,007 women and 2,886 men enrolled in the first National Health and Nutrition Examination Survey (NHANES I), who did not have CHD at the 1982-1984 interview and had been evaluated for depression.

Participants were followed until 1992, the year of the final follow-up interview of the study. According to the authors, this study is unique in that it analyzed the data separately for men and women and it is the first study to demonstrate that depression affects CHD risk in women. "We have shown that the effect of depression on CHD risk differs in men and women," the authors comment. At baseline, 17.5 percent of women and 9.7 percent of men were classified as depressed. During the study period, women experienced 187 nonfatal and 137 fatal CHD events; men experienced 187 nonfatal and 129 fatal CHD events.

The authors found that depressed women were at 73 percent greater risk for CHD events than women who were not depressed but were not at increased risk of dying from CHD. Depressed men had a 71 percent greater risk of CHD incidence and 2.34 times the risk of dying from CHD than men who were not depressed. The authors recommend further research to define the mechanism that links depression to elevated CHD risk in patients without heart disease so interventions can be established to reduce CHD risk.

Editor's Note: To contact lead author Amy K. Ferketich, MA, from The Ohio State University College of Medicine and Public Health, Columbus, call David Crawford at 614-293-3737.

(Arch Intern Med. 2000;160:1261-1268)

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