Depression and the risk for cardiovascular diseases: systematic review and meta analysis

TLDR

Depression and cardiovascular disease are common in the elderly, and depression is suspected to be an independent risk factor for coronary heart disease and other circulatory disorders. The study aimed to estimate depression’s independent risk for various cardiovascular diseases and examine heterogeneity and methodological quality. Meta‑analyses and meta‑regression of longitudinal cohort and case‑control studies were performed using data from MEDLINE and PSYCHINFO (1966–2005) on baseline depression and follow‑up CVD outcomes. Among 28 studies (11 high quality), depression increased risk for many CVDs but heterogeneity was substantial; only myocardial infarction showed a homogeneous risk (OR 1.60, 95 % CI 1.34–1.92), and clinically diagnosed major depressive disorder was the strongest risk factor. © 2007 John Wiley & Sons, Ltd.

Abstract

Abstract Background Depression and cardiovascular diseases are both common among elderly. Depression is suspected to be an independent risk factor for the onset of coronary heart disease, yet it is not clear to what extent and if depression also is associated with the onset of other diseases of the circulatory system. Aims To estimate the risk of depression as an independent risk factor for various cardiovascular diseases (CVD) and explore the effects of heterogeneity and methodological quality. Method Meta‐analyses and meta‐regression analyses of longitudinal cohort and case‐control studies reporting depression at baseline and CVD outcomes at follow‐up. Data sources MEDLINE (1966–2005) and PSYCHINFO (1966–2005). Results Of the 28 studies that met the inclusion criteria, 11 were assesed as high quality studies. Although depressed mood increased the risk for a wide range of CVDs, heterogeneity was substantial in most cases. Only the overall combined risk of depression for the onset of myocardial infarctions ( n =8, OR=1.60, 95%CI 1.34–1.92) was homogenous. Clinically diagnosed major depressive disorder was identified as the most important risk factor for developing CVD. Conclusions Depression seems to be an independent risk factor for the onset of a wide range of CVDs, although this evidence is related to a high level of heterogeneity. Copyright © 2007 John Wiley & Sons, Ltd.