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Depression linked to heart disease in younger women

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Women aged 55 and younger who are depressed are twice as likely to suffer a heart attack, die, or require artery-opening procedures, according to a new study from the American Heart Association. Additionally, women in this age group are more likely than men and older women to have depression. This could possibly be a “hidden” heart-disease risk factor which could explain why more women die after a heart attack than men.

“Women in this age group are also more likely to have depression, so this may be one of the ‘hidden’ risk factors that can help explain why women die at a disproportionately higher rate than men after a heart attack,” says Amit Shah, MD, MSCR, study author and assistant professor of Epidemiology at Emory University in Atlanta, Ga.

Investigators looked at symptoms of depression in 3,237 people with known or suspected heart disease; 34 percent were women, and the average age was 62.5. Participants were scheduled for coronary angiography, an X-ray that diagnoses disease in the arteries that supply blood to the heart.

After nearly three years, they found:

  • In women 55 and younger, after adjusting for other heart disease risk factors, each one-point increase in symptoms of depression was associated with a seven percent increase in heart disease.
  • In men and older women, symptoms of depression didn’t predict the presence of heart disease.
  • Women 55 and younger were 2.17 times as likely to suffer a heart attack, die of heart disease, or require an artery-opening procedure during the follow-up period if they had moderate or severe depression.
  • Women 55 and younger were 2.45 times as likely to die from any cause during the follow-up period if they had moderate or severe depression.

“All people, and especially younger women, need to take depression very seriously,” Shah says. “Depression itself is a reason to take action, but knowing that it is associated with an increased risk of heart disease and death should motivate people to seek help. Providers need to ask more questions. They need to be aware that young women are especially vulnerable to depression, and that depression may increase the risk to their heart.”

Viola Vaccarino, MD, PhD, senior author of the study and Wilton Looney Chair of Epidemiology at Emory, says the study indicates young women may need to be screened for depression. “Although the risks and benefits of routine screening for depression are still unclear, our study suggests that young women may benefit for special consideration,” she says. “Unfortunately, this group has largely been understudied before.”

In 2008, the American Heart Association issued a scientific statement recommending that depression be formally considered as a risk factor, like diabetes or hypertension, for increased heart-disease risk. “Our data are in accordance with this recommendation, but suggest that young/middle aged women may be especially vulnerable to depression as a risk factor,” Vaccarino adds.

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