Depression may be a risk factor for coronary heart disease in midlife women <65 years: A 9-year prospective cohort study

Int J Cardiol. 2018 Nov 15:271:8-12. doi: 10.1016/j.ijcard.2018.05.085. Epub 2018 May 24.

Abstract

Objective: Depression has been suggested as a risk factor for coronary heart disease (CHD). However, whether the risk may be affected by age is unknown. We seek to assess the difference in long-term CHD risk between younger (<65) and older (≥65) women with depressive symptoms.

Methods: Between June and August 2004, 1995 women presenting for routine mammography were enrolled to the primary study on breast arterial calcification. In 2005 (year 2), each woman completed a validated depression screening questionnaire. A similar questionnaire was mailed to each participant at year 4, 5, and 10 to obtain follow-up data (demographic and CHD risk factors) and record any change in CHD status.

Results: Of 1084 women who returned surveys at year 10, 998 had no history of CHD and answered depression screening questions at year 2 as well as questions about CHD events at year 10. Of 185 out of 998 (18.5%) who had positive depression screening at year 2, 24 (13.0%) developed ≥1 CHD events by year 10, which is significantly higher than the incidence of 6.5% (53/813) in control group (p < 0.001). With CHD risk factors including age adjusted in a logistic regression model, depression was the only significant predictive factor for CHD in women aged <65 (OR = 6.56, 95% CI 1.07-40.09, p = 0.042). However, in women aged ≥65, age was the only significant predictive factor for CHD.

Conclusion: A history of depression may increase the risk of CHD over 9 years of follow-up, and more prominently in midlife women aged <65 years.

Keywords: Coronary heart disease; Depression; Midlife women.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Coronary Disease / diagnosis
  • Coronary Disease / epidemiology*
  • Coronary Disease / psychology*
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Time Factors