Depression increases the risk of cardiovascular disease


The risk of cardiovascular disease would increase in people with symptoms of depression.

The researchers studied more than 7,300 elderly people in France with no history of heart disease, stroke, or dementia at the start of the study period. About 30% of women and 15% of men had high levels of depressive symptoms.

Participants were reassessed two, four, and seven years later. At each follow-up visit, about 40% of depressed people no longer showed symptoms of depression, while the same percentage had instead developed symptoms. Less than 10 percent of participants were taking antidepressant medication.

Those who had high levels of depressive symptoms at each visit had an increased risk of heart disease or stroke within 10 years. This risk increased by 75% for individuals who had symptoms of depression at each of the four visits.

The results suggest that depression could be a risk factor for cardiovascular disease. However, they do not allow us to conclude that there is a cause-and-effect relationship.

The authors of the study (Dr Renaud Pequignot, INSERM, Paris) suggest that doctors should closely monitor people aged 65 and over with depression.

According to the World Health Organization, depression, and cardiovascular disease are the leading causes of disability and death, respectively. Depression increases the likelihood of having cardiovascular disease and vice versa.

Source: Péquignot R. et al. High Level of Depressive Symptoms at Repeated Study Visits and Risk of Coronary Heart Disease and Stroke over 10 Years in Older Adults: The Three-City Study. Journal of the American Geriatrics Society, 2016; 64 (1): 118.

Another study reported that depressive symptoms in women have been linked to a greater risk of heart disease, as up to 25% of women experience depression in their lifetimes. Such depressive symptoms may be considered an emergent, non-traditional risk factor that can increase the chances of developing cardiovascular disease (CVD).

A link between depression and stroke, a form of cardiovascular disease

Australian researchers have found that women with depression have a 2.4 times greater risk of stroke than those without
« When physicians care for their patients, they need to determine the severity of their mood disorders and the long-term adverse effects they may have, » said Caroline Jackson, Ph.D., study author. and epidemiologist at the University of Queensland in Australia. “Current stroke prevention guidelines tend to overlook the potential role of depression. »

This large-scale study examined the association between depression and stroke in 10,547 middle-aged women (47-52 years old) who had to answer questionnaires about their physical and mental health. About 24% of the participants said they were depressed.

A previous study reported a 30% increased risk in participants who were on average 14 years older. Although depression is associated with an increased risk of stroke, the absolute risk of stroke remains low (2%) for this age group.

The researcher does not know the reason for the association between depression and stroke.

“Inflammatory and immune mechanisms with adverse effects on blood vessels could be the cause,” says Dr. Jackson.

Source: Depression linked to almost doubled stroke risk in middle-aged women (source: Stroke, May 2013).

In 2012, a meta-analysis published in the journal Stroke and listing 17 articles confirmed the existence of a link between the presence of depression and an increased risk (+34%) of stroke, considering the body mass index, smoking, high blood pressure, and diabetes. This correlation is similar for both men and women, although the prevalence of depression is higher in women. However, this study does not show that depression is the cause.

Depression is a modifiable risk factor for heart disease.

Another study confirms that symptoms of depression are causally linked to an increased risk of cardiovascular disease, suggesting that depression is a modifiable risk factor for heart disease.

The study involved over 10,000 English individuals whose mental state was assessed 6 times over a 20-year period.

The risk of coronary heart disease doubles when these people report depressive symptoms during at least 3 assessments.

However, no association between depression and stroke has been reported. According to the author of the study, depression is not a cause of stroke, but rather a consequence of the presence of vascular disease.

Psychological distress (including depression) increases stroke deaths

According to a meta-analysis of 68,000 English people, subjects with symptoms of psychological distress (anxiety, depression, social problems or loss of confidence) have an increased risk of death ranging from 16% (if symptoms of psychological distress are mild) to 67% (if symptoms are high).

These deaths are caused by a heart attack or stroke (and in the case of high symptoms, cancer). Researchers have hypothesized that acute stress can reduce blood flow to the heart or that depression can lead to increased levels of inflammation (source: British Medical Journal, July 2012).

The risk of heart attacks and strokes can be halved if depressive symptoms are treated before signs of cardiovascular disease appear.

This study confirms that depression increases the risk of cardiovascular disease, and emphasizes the need to treat depression before the onset of these diseases, to reduce the consequences on the heart (heart attack) and the brain (stroke).

Researchers followed 235 depressive patients for 8 years. The risk of heart attack and stroke was reduced by 48% in those who received both psychotherapy and antidepressant medication, compared to those who did not.

Source: Effect of Collaborative Care for Depression on Risk of Cardiovascular Events: Data From the IMPACT Randomized Controlled Trial. Psychosomatic Medicine, 2013; 76 (1): 29.