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Depression and cardiac mortality: results from a community-based longitudinal study
B W Penninx1, A T Beekman, A Honig
1Institute for Research in Extramural Medicine, Vrije University, Amsterdam, The Netherlands. bpenninx@wfubmc.edu
Insights
Depression significantly increases cardiac mortality risk in both cardiac and non-cardiac patients. Major depression poses a higher risk than minor depression for heart-related deaths.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Depression is a potential risk factor for cardiac death.
- The impact of depression on cardiac mortality may vary based on cardiac disease status.
- This study investigates depression's effect on cardiac mortality in individuals with and without pre-existing heart conditions.
Purpose of the Study:
- To examine and compare the effect of depression on cardiac mortality.
- To assess depression's impact on cardiac mortality in community-dwelling individuals with and without cardiac disease.
Main Methods:
- A cohort of 2847 adults aged 55-85 years was followed for 4 years.
- Major depression was diagnosed using DSM-III criteria; minor depression was identified using the Center for Epidemiologic Studies-Depression Scale.
- Cardiac mortality risks associated with minor and major depression were analyzed separately for individuals with and without cardiac disease, adjusting for multiple confounding variables.
Main Results:
- Among cardiac patients, minor depression increased cardiac mortality risk by 1.6 times and major depression by 3.0 times.
- In individuals without cardiac disease, minor depression showed a 1.5-fold and major depression a 3.9-fold increased risk of cardiac mortality.
- The relative risk of cardiac mortality was consistently higher for major depression compared to minor depression in both groups.
Conclusions:
- Depression is a significant risk factor for cardiac mortality, irrespective of baseline cardiac disease status.
- Major depression confers a substantially higher excess cardiac mortality risk compared to minor depression.
- These findings highlight the importance of addressing depression in cardiovascular health management.
Background:
Depression may be a potential risk factor for subsequent cardiac death. The impact of depression on cardiac mortality has been suggested to depend on cardiac disease status, and to be stronger among cardiac patients. This study examined and compared the effect of depression on cardiac mortality in community-dwelling persons with and without cardiac disease.
Methods:
A cohort of 2847 men and women aged 55 to 85 years was evaluated for 4 years. Major depression was defined according to psychiatric DSM-III criteria. Minor depression was defined by Center for Epidemiologic Studies-Depression Scale scores of 16 or higher. Effects of minor and major depression on cardiac mortality were examined separately in 450 subjects with a diagnosis of cardiac disease and in 2397 subjects without cardiac disease after adjusting for demographics, smoking, alcohol use, blood pressure, body mass index, and comorbidity.
Results:
Compared with nondepressed cardiac patients, the relative risk of subsequent cardiac mortality was 1.6 (95% confidence interval [CI], 1.0-2.7) for cardiac patients with minor depression and 3.0 (95% CI, 1.1-7.8) for cardiac patients with major depression, after adjustment for confounding variables. Among subjects without cardiac disease at baseline, similar increased cardiac mortality risks were found for minor depression (1.5 [95% CI, 0.9-2.6]) and major depression (3.9 [95% CI, 1.4-10.9]).
Conclusion:
Depression increases the risk for cardiac mortality in subjects with and without cardiac disease at baseline. The excess cardiac mortality risk was more than twice as high for major depression as for minor depression.