This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (145)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Men's Health  • Women's Health  • Women's Health, Other  • Psychiatry  • Depression  • Alert me on articles by topic

Amy K. Ferketich, MA; Judith A. Schwartzbaum, PhD; David J. Frid, MD; Melvin L. Moeschberger, PhD

Arch Intern Med. 2000;160:1261-1268.

Background  Depression predicts morbidity and mortality among individuals who have coronary heart disease (CHD), and there is increasing evidence that depression may also act as an antecedent to CHD. The studies that have reported a relationship between depression and CHD incidence or mortality either were restricted to men only or analyzed women and men together. The present investigation was conducted to evaluate the differential effect depression may have on CHD incidence and mortality in women and men.

Research Methods  We analyzed data from 5007 women and 2886 men enrolled in the first National Health and Nutrition Examination Survey (NHANES I) who were free of CHD at the 1982-1984 interview and who had completed the Center for Epidemiologic Studies Depression Scale (CES-D). Participants were evaluated from the 1982 interview date either until the end of the study (1992 interview date) or until the occurrence of a CHD event. Using CHD incidence and CHD mortality (International Classification of Disease, Ninth Revision, codes 410-414) as the outcome variables, Cox proportional hazards regression models were developed to evaluate the relative risk (RR) of CHD incidence and mortality in the depressed women and men separately, controlling for standard CHD risk factors.

Results  The women experienced 187 nonfatal and 137 fatal events, compared with 187 nonfatal and 129 fatal events among the men. The adjusted RR of CHD incidence among depressed women was 1.73 (95% confidence internal [CI], 1.11-2.68) compared with nondepressed women. Depression had no effect on CHD mortality in the women (RR, 0.74; 95% CI, 0.40-1.48). The adjusted RR of CHD incidence among depressed men was 1.71 (95% CI, 1.14-2.56) compared with nondepressed men. Depressed men also had an increased risk of CHD mortality compared with their nondepressed counterparts, with an adjusted RR of 2.34 (95% CI, 1.54-3.56).

Conclusions  In this sample, while controlling for possible confounding factors, depression was associated with an increased risk of CHD incidence in both men and women, as well as CHD mortality in men. Depression had no effect on CHD mortality in women.

From the Division of Epidemiology and Biometrics (Ms Ferketich and Drs Schwartzbaum and Moeschberger) and Department of Internal Medicine (Dr Frid), The Ohio State University College of Medicine and Public Health, Columbus.

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(9):1379-1380.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Disturbed Glucose Disposal in Patients With Major Depression; Application of the Glucose Clamp Technique
Schweiger et al.
Psychosom. Med. 2008;70:170-176.
ABSTRACT | FULL TEXT  

Depression, Inflammation, and Incident Cardiovascular Disease in Women With Suspected Coronary Ischemia: The National Heart, Lung, and Blood Institute Sponsored WISE Study
Vaccarino et al.
J Am Coll Cardiol 2007;50:2044-2050.
ABSTRACT | FULL TEXT  

Major Depressive Disorder and Comorbid Cardiac Disease: Is There a Depressive Subtype With Greater Cardiovascular Morbidity? Results From the STAR*D Study
Fraguas et al.
Psychosomatics 2007;48:418-425.
ABSTRACT | FULL TEXT  

Lifetime Major Depression is Associated With Coronary Heart Disease in Older Adults: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
Herbst et al.
Psychosom. Med. 2007;69:729-734.
ABSTRACT | FULL TEXT  

Physical Activity: Depression, Anxiety, Physical Activity, and Cardiovascular Disease: What's the Connection?
Zoeller
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:175-180.
ABSTRACT  

Self-Reported Depression and Cardiovascular Risk Factors in a Community Sample of Women
Jacka et al.
Psychosomatics 2007;48:54-59.
ABSTRACT | FULL TEXT  

Are Mood Disorders a Stroke Risk Factor?
Carod-Artal
Stroke 2007;38:1-3.
FULL TEXT  

Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies
Nicholson et al.
Eur Heart J 2006;27:2763-2774.
ABSTRACT | FULL TEXT  

Psychosocial factors and coronary calcium in adults without clinical cardiovascular disease.
Diez Roux et al.
ANN INTERN MED 2006;144:822-831.
ABSTRACT | FULL TEXT  

The association of psychological factors, physical activity, neuropathy, and quality of life in type 2 diabetes.
Chyun et al.
Biol Res Nurs 2006;7:279-288.
ABSTRACT  

Depressive symptoms in urban population samples in Russia, Poland and the Czech Republic
BOBAK et al.
Br. J. Psychiatry 2006;188:359-365.
ABSTRACT | FULL TEXT  

Depression is associated with cardiac symptoms, mortality risk, and hospitalization among women with suspected coronary disease: the NHLBI-sponsored WISE study.
Rutledge et al.
Psychosom. Med. 2006;68:217-223.
ABSTRACT | FULL TEXT  

Dispositional optimism and the risk of cardiovascular death: the zutphen elderly study.
Giltay et al.
Arch Intern Med 2006;166:431-436.
ABSTRACT | FULL TEXT  

Clinical Depression and Risk of Out-of-Hospital Cardiac Arrest
Empana et al.
Arch Intern Med 2006;166:195-200.
ABSTRACT | FULL TEXT  

C-reactive protein, depressed mood, and the prediction of coronary heart disease in initially healthy men: results from the MONICA-KORA Augsburg Cohort Study 1984-1998
Ladwig et al.
Eur Heart J 2005;26:2537-2542.
ABSTRACT | FULL TEXT  

Trends in the Prescribing of Antidepressants Following Acute Myocardial Infarction, 1993-2002
Benazon et al.
Psychosom. Med. 2005;67:916-920.
ABSTRACT | FULL TEXT  

Depressive Symptoms, Coronary Heart Disease, and Overall Mortality in the Framingham Heart Study
Wulsin et al.
Psychosom. Med. 2005;67:697-702.
ABSTRACT | FULL TEXT  

Contributions of Depressive Mood and Circulating Inflammatory Markers to Coronary Heart Disease in Healthy European Men: The Prospective Epidemiological Study of Myocardial Infarction (PRIME)
Empana et al.
Circulation 2005;111:2299-2305.
ABSTRACT | FULL TEXT  

Gender Differences in the Link Between Depression and Cardiovascular Disease
Naqvi et al.
Psychosom. Med. 2005;67:S15-S18.
ABSTRACT | FULL TEXT  

Reflections on Depression as a Cardiac Risk Factor
Frasure-Smith and Lesperance
Psychosom. Med. 2005;67:S19-S25.
ABSTRACT | FULL TEXT  

Inflammatory Markers and Sleep Disturbance in Major Depression
Motivala et al.
Psychosom. Med. 2005;67:187-194.
ABSTRACT | FULL TEXT  

Psychological distress, physical illness, and risk of coronary heart disease
Rasul et al.
J. Epidemiol. Community Health 2005;59:140-145.
ABSTRACT | FULL TEXT  

Depressive Symptoms and Development of Coronary Heart Disease Events: The Italian Longitudinal Study on Aging
Marzari et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:85-92.
ABSTRACT | FULL TEXT  

Psychologic Distress in Postmyocardial Infarction Patients Who Have Returned to Work
Brisson et al.
Psychosom. Med. 2005;67:59-63.
ABSTRACT | FULL TEXT  

Heart and mind: (1) relationship between cardiovascular and psychiatric conditions
Shah et al.
Postgrad. Med. J. 2004;80:683-689.
ABSTRACT | FULL TEXT  

C-Reactive Protein Is Associated With Psychological Risk Factors of Cardiovascular Disease in Apparently Healthy Adults
Suarez
Psychosom. Med. 2004;66:684-691.
ABSTRACT | FULL TEXT  

Anxiety or depressive disorders and risk of ischaemic heart disease among French power company employees
Allonier et al.
Int J Epidemiol 2004;33:779-786.
ABSTRACT | FULL TEXT  

Depression as a Risk Factor for Coronary Artery Disease: Evidence, Mechanisms, and Treatment
Lett et al.
Psychosom. Med. 2004;66:305-315.
ABSTRACT | FULL TEXT  

Community-Integrated Home-Based Depression Treatment in Older Adults: A Randomized Controlled Trial
Ciechanowski et al.
JAMA 2004;291:1569-1577.
ABSTRACT | FULL TEXT  

Depression and Cardiovascular Sequelae in Postmenopausal Women: The Women's Health Initiative (WHI)
Wassertheil-Smoller et al.
Arch Intern Med 2004;164:289-298.
ABSTRACT | FULL TEXT  

Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study
Prescott et al.
Int J Epidemiol 2003;32:990-997.
ABSTRACT | FULL TEXT  

Depression and cardiovascular morbidity and mortality: cause or consequence?
Stewart et al.
Eur Heart J 2003;24:2027-2037.
ABSTRACT | FULL TEXT  

Association Between Depression and Elevated C-Reactive Protein
Danner et al.
Psychosom. Med. 2003;65:347-356.
ABSTRACT | FULL TEXT  

Depression and Coronary Heart Disease in Women With Diabetes
Clouse et al.
Psychosom. Med. 2003;65:376-383.
ABSTRACT | FULL TEXT  

Assessing Depression in the Cardiac Patient: When Is the Appropriate Time to Assess Depression in the Patient Undergoing Coronary Revascularization?
Poston et al.
Behav Modif 2003;27:26-36.
ABSTRACT  

Arterial endothelial function is impaired in treated depression
Broadley et al.
Heart 2002;88:521-523.
ABSTRACT | FULL TEXT  

Commentary: The problem with stress: minds, hearts and disease
Stansfeld
Int J Epidemiol 2002;31:1113-1116.
FULL TEXT  

Depression and Coronary Artery Atherosclerosis and Reactivity in Female Cynomolgus Monkeys
Shively et al.
Psychosom. Med. 2002;64:699-706.
ABSTRACT | FULL TEXT  

Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina
Glassman et al.
JAMA 2002;288:701-709.
ABSTRACT | FULL TEXT  

Psychological Factors in Heart Failure: A Review of the Literature
MacMahon and Lip
Arch Intern Med 2002;162:509-516.
ABSTRACT | FULL TEXT  

Erectile Dysfunction and Quality of Life in Type 2 Diabetic Patients: A serious problem too often overlooked
De Berardis et al.
Diabetes Care 2002;25:284-291.
ABSTRACT | FULL TEXT  

Psychological distress as a risk factor for coronary heart disease in the Whitehall II Study
Stansfeld et al.
Int J Epidemiol 2002;31:248-255.
ABSTRACT | FULL TEXT  

Excess Mortality in Bipolar and Unipolar Disorder in Sweden
Osby et al.
Arch Gen Psychiatry 2001;58:844-850.
ABSTRACT | FULL TEXT  

Job Stress, Control, and Chronic Disease: Moving to the Next Level of Evidence
Pickering
Psychosom. Med. 2001;63:734-736.
FULL TEXT  

Depression and Risk of Heart Failure Among Older Persons With Isolated Systolic Hypertension
Abramson et al.
Arch Intern Med 2001;161:1725-1730.
ABSTRACT | FULL TEXT  

Prospective Study of Depressive Symptoms and Risk of Stroke Among Japanese Editorial Comment : Is Depression a Risk Factor for Ischemic Stroke?
Ohira et al.
Stroke 2001;32:903-908.
ABSTRACT | FULL TEXT  

Psychological Factors and Coronary Artery Disease
Pickering et al.
NEJM 2001;344:608-611.
FULL TEXT  

Psychological Heart Disease?
Irani
Arch Intern Med 2001;161:485-486.
FULL TEXT