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Depression in women increases mortality risk

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Women under 55 with depression double their risk for mortality or heart attack

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Women suffer from depression twice as often as men. One out of four women may have depression sometime during their lifetime.

Young women with coronary heart disease have high rates of depression and a higher risk of adverse events than men of similar age. Whether depression has a higher predictive value in this group than in men and older women is not known.

Dr. Amit Shah, MD, MSCR, Assistant Professor at Emory University, Staff Cardiologist at Atlanta Veterans Affairs Medical Center and author of study, along with colleagues examined whether depression in young women is associated with higher risk of coronary artery disease (CAD) and adverse outcomes compared with similarly aged men and older women.

The research team examined 3,237 patients (34 percent women, average age 62.5 years) undergoing coronary angiography for evaluation of CAD and filled out a patient questionnaire (PHQ)‐9) which examines a patients severity of depression , Patients were followed for an average of 2.9 years.

After adjusting for CAD risk factors, depressive symptoms predicted CAD presence in women aged 55 and under. For each point of symptoms of depression was linked to a 7% increase of the presence of heart disease however, this association was not seen men aged 55 and under or women over age 55.

In women aged 55 and younger who had moderate or severe depression had two times the risk to have a heart attack, heart disease or die from heart disease in the next few years compared to women who were not depressed.

Dr. Shah commented "All people, and especially younger women, need to take depression very seriously.” "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."

Dr. Shah continued "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.”

Dr. Viola Vaccarino, MD, PhD, Professor and Chair, Department of Epidemiology, Rollins School of Public Health, Emory University, with a joint appointment in the Department of Medicine, Division of Cardiology, Emory University School of Medicine and senior author of study commented “Although the risks and benefits of routine screening for depression are still unclear, our study suggests that young women may benefit for special consideration.” "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.

Dr. Roy C. Ziegelstein, Professor of Medicine and Executive Vice Chairman, Department of Medicine; Deputy Director for Education, Johns Hopkins Bayview Medical Center in an article concerning depression commented “What we can say with certainty is that depression and heart disease often occur together.” About one in five who have a heart attack are found to have depression soon after the heart attack. And it’s at least as prevalent in people who suffer heart failure.”

“Depression and heart disease are among the most disabling diseases we face. They are both very widespread among the general population and often occur simultaneously in the same individual,” writes Dr. Ziegelstei.

Information about heart disease and women can be found online at Go Red For Women.

This study is published in the Journal of the American Heart Association.

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