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Depression may be a risk factor for heart disease, death in older women

The JAMA Network Journals

CHICAGO - Older women with symptoms of depression may be at an increased risk of heart disease and death, according to an article in the February 9 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.

Previous studies report that depressive symptoms, including subthreshold symptoms that do not warrant a clinical diagnosis of depression, may be independent risk factors for cardiovascular-related deaths.

Sylvia Wassertheil-Smoller, Ph.D., of Albert Einstein College of Medicine, Bronx, N.Y., and colleagues investigated the association between depressive symptoms and cardiovascular events (including heart attack and stroke) in 93,676 healthy, older women who participated in the Women's Health Initiative Observational Study (WHI-OS). The WHI-OS is a long-term study to identify and assess the impact of biological, lifestyle, biochemical, and genetic factors on the risk of heart disease, cancer, osteoporosis, and other major health problems in older women. The data the researchers used was from women who enrolled in the WHI-OS between September 1993 and December 1998. Participants were evaluated for depressive symptoms and cardiovascular disease (CVD) risk factors when they enrolled in the WHI-OS, and were followed up for an average of 4.1 years.

The researchers found that depressive symptoms were reported by 15.8 percent of women, and depression was significantly related to CVD risk. Women were 12 percent more likely to have hypertension and 60 percent more likely to have a history of stroke or angina if they had depressive symptoms. Among women with no history of CVD, depression was an independent predictor of death from cardiovascular disease (50 percent more likely) or death from any other cause (32 percent more likely).

"A large proportion of older women report levels of depressive symptoms that are significantly related to increased risk of CVD death and all-cause mortality [death from any cause], even after controlling for established CVD risk factors," the authors write. "Whether early recognition and treatment of subclinical depression will lower CVD risk remains to be determined in clinical trials."

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(Arch Intern Med. 2004;164:289-298. Available post-embargo at archinternmed.com)
Editor's Note: This research was performed pursuant to contracts for WHI with the National Institutes of Health, Department of Health and Human Services, Bethesda, Md.

To contact Sylvia Wassertheil-Smoller, Ph.D., call Karen Gardner at 718-430-3101.
For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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