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Does Depression Specifically Increase Cardiovascular Mortality?

Does Depression Specifically Increase Cardiovascular Mortality? With interest, we have read the article of Wassertheil-Smoller et al1 on depression and cardiovascular sequelae in postmenopausal women. The authors report that depression is an independent risk factor for cardiovascular mortality and all-cause mortality among postmenopausal women being studied in the Women’s Health Initiative Observation Study. However, as the effect of depression on noncardiovascular mortality is not described, it remains unclear whether depression specifically increases cardiovascular mortality. Therefore, we calculated the mortality risks of depressed women by using the event rates as presented by the authors. It appears that depressed women were at an increased risk for both cardiovascular (relative risk, 1.52; 95% confidence interval, 1.26-1.83) and noncardiovascular mortality (relative risk, 1.25; 95% confidence interval, 1.12-1.40) (Table). Therefore, it is more likely that depression increases mortality through aspecific mechanisms such as noncompliance with medical treatment rather than through specific biological mechanisms affecting cardiovascular disease risk.2 We do not know if this conclusion extends to women without cardiovascular disease at baseline because we could not calculate the noncardiovascular mortality in these subjects from the presented data. Table. View LargeDownload Calculated Mortality Risks for All Subjects in the Women’s Health Initiative Observation Study* Correspondence: Dr Vinkers, Leiden University Medical Center (LUMC), Section of Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, the Netherlands (d.j.vinkers@lumc.nl). References 1. Wassertheil-Smoller SShumaker SOckene J et al. Depression and cardiovascular sequelae in postmenopausal women. Arch Intern Med 2004;164289- 298PubMedGoogle ScholarCrossref 2. Dimatteo MRLepper HSCroghan TW Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;1602101- 2107PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Does Depression Specifically Increase Cardiovascular Mortality?

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Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.165.1.119-a
Publisher site
See Article on Publisher Site

Abstract

With interest, we have read the article of Wassertheil-Smoller et al1 on depression and cardiovascular sequelae in postmenopausal women. The authors report that depression is an independent risk factor for cardiovascular mortality and all-cause mortality among postmenopausal women being studied in the Women’s Health Initiative Observation Study. However, as the effect of depression on noncardiovascular mortality is not described, it remains unclear whether depression specifically increases cardiovascular mortality. Therefore, we calculated the mortality risks of depressed women by using the event rates as presented by the authors. It appears that depressed women were at an increased risk for both cardiovascular (relative risk, 1.52; 95% confidence interval, 1.26-1.83) and noncardiovascular mortality (relative risk, 1.25; 95% confidence interval, 1.12-1.40) (Table). Therefore, it is more likely that depression increases mortality through aspecific mechanisms such as noncompliance with medical treatment rather than through specific biological mechanisms affecting cardiovascular disease risk.2 We do not know if this conclusion extends to women without cardiovascular disease at baseline because we could not calculate the noncardiovascular mortality in these subjects from the presented data. Table. View LargeDownload Calculated Mortality Risks for All Subjects in the Women’s Health Initiative Observation Study* Correspondence: Dr Vinkers, Leiden University Medical Center (LUMC), Section of Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, the Netherlands (d.j.vinkers@lumc.nl). References 1. Wassertheil-Smoller SShumaker SOckene J et al. Depression and cardiovascular sequelae in postmenopausal women. Arch Intern Med 2004;164289- 298PubMedGoogle ScholarCrossref 2. Dimatteo MRLepper HSCroghan TW Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;1602101- 2107PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 10, 2005

Keywords: depressive disorders,cardiovascular death

References