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La depresión y el riesgo de morbilidad y mortalidad por accidente cerebrovascular: un metanálisis y revisión
An Pan1, Qi Sun, Olivia I Okereke
1Department of Nutrition, Harvard School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA.
JAMA
|September 22, 2011
Resumen
La depresión aumenta significativamente el riesgo de accidente cerebrovascular, incluidos los tipos fatales e isquémicos. Este metanálisis confirma un vínculo consistente entre la depresión y una mayor incidencia y mortalidad por accidente cerebrovascular.
Área de la Ciencia:
- Neurología Neurología.
- La psiquiatría es la psiquiatría.
- Epidemiología La epidemiología.
Sus antecedentes:
- La investigación existente sugiere un vínculo entre la depresión y el aumento del riesgo de accidente cerebrovascular, pero los hallazgos son inconsistentes.
- La depresión es una condición de salud mental prevalente con implicaciones significativas para la salud pública.
Objetivo del estudio:
- Revisar sistemáticamente y metaanalizar estudios prospectivos sobre la asociación entre la depresión y el riesgo de accidente cerebrovascular en adultos.
- Proporcionar una evaluación integral de la evidencia que vincula la depresión con la morbilidad y mortalidad por accidente cerebrovascular.
Principales métodos:
- Buscado en las bases de datos MEDLINE, EMBASE y PsycINFO, complementado con búsquedas manuales.
- Se incluyeron 28 estudios de cohorte prospectivos con 317.540 participantes y 8478 casos de accidente cerebrovascular.
- Relaciones de peligro ajustadas (RR) agrupadas utilizando modelos de efecto fijo o de efectos aleatorios; sesgo de publicación evaluado.
Principales resultados:
- Se observó una HR ajustada agrupada de 1,45 (95% IC, 1,29-1,63) para el accidente cerebrovascular total.
- Se encontraron mayores riesgos para el accidente cerebrovascular fatal (HR = 1,55) y el accidente cerebrovascular isquémico (HR = 1,25).
- Las diferencias de riesgo absoluto indicaron un adicional de 106 casos totales de accidente cerebrovascular por cada 100.000 individuos anualmente debido a la depresión.
Conclusiones:
- La depresión se asocia significativamente con un mayor riesgo de morbilidad y mortalidad por accidente cerebrovascular.
- Los hallazgos destacan la importancia de abordar la depresión en las estrategias de prevención del accidente cerebrovascular.
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