Depression Tied to Coronary Artery Disease Risk in Women

Nearly 2000 women underwent screening to determine if a link exists between depression or depressive symptoms and coronary artery disease.

A history of depression or depressive symptoms can be linked to an increased risk of developing coronary artery disease (CAD), especially in women aged 65 years or younger, according to research presented at the North American Menopause Society (NAMS) 2016 Annual Meeting.

Xuezhi Jiang, MD, an obstetrician/gynecologist at the Reading Hospital in West Reading, Pennsylvania, and the Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia, and colleagues conducted a 10-year prospective longitudinal study of women aged 65 and older to determine the link between depression and CAD.

Depression screening was conducted in 1995 consecutive women undergoing routine breast cancer screening mammography at 4 outpatient radiology facilities. The modified depression questionnaire asked the women if they often felt sad or depressed, helpless, and downhearted and blue. Baseline relevant CAD history—including history of hypertension, diabetes, hypercholesterolemia, smoking, menopausal status, family history of CAD, exercise intensity, and hormonal therapy use—was also collected. A questionnaire was mailed to each of the 1919 participants for whom baseline data were available during the 2nd, 4th, 5th, and 10th years of study follow-up.

At the 10-year follow-up, 1084 surveys were returned (participant mean age: 54.8±11 years). More than 18% of the 1030 women with no history of CAD at baseline answered “yes” to at least 1 query on the questionnaire. Of those women, 9% had developed at least 1 CAD event by year 10 vs the 2.1% (P <.001) who answered “no” to all 3 questions.

Additionally, Dr Jiang and colleagues identified a trend between number of questions answered “yes”—1, 2, or 3 questions—and incidence of CAD by year 10 (P <.001). They also noted that the odds ratio (OR) for depression was unaffected by age (OR: 6.56; 95% CI, 1.07-40.09; P =.042), but in women younger than 65, depression was the only significant risk factor for CAD.

“We saw a significant difference in the association of depression with the risk for CAD based on a patient’s age. Compared with women aged 65 years and older, women under the age of 65 were far more likely to incur CAD as a result of depression,” Dr Jiang said in a press release.

“This study highlights the need for health care providers to screen women for signs of depression, especially if they are younger, in order to be more proactive in helping them manage their risk for CAD,” JoAnn Pinkerton, MD, NAMS executive director, said in the release.

Disclosures: The authors report no conflicts of interest. Dr Pinkerton reports relationships with Henry Stewart, Pfizer, and TherapeuticsMD.

For more coverage of the NAMS 2016 Annual Meeting, click here.

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  1. Jiang X, Asmaro R, O’Sullivan DO, Budnik E, Schnatz PF. Abstract S-17. Depression may be one of the strongest risk factors for coronary artery disease in women aged <65 years: A 10-year prospective longitudinal study. Presented at: NAMS 2016 Annual Meeting; October 5-8, 2016; Orlando, FL.
  2. Depression linked to increased risk of heart disease [press release]. Cleveland, OH: NAMS Press Room; September 19, 2016. Accessed October 4, 2016.