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Does Depression Specifically Increase Cardiovascular Mortality? In Reply
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We thank Vinkers and colleagues for their comments about our article describing the association between depression and subsequent cardiovascular events.1 Vinkers et al raise the interesting question of whether the increased risk of cardiovascular mortality associated with depression may act through noncompliance with treatment on the part of those depressed rather than through a biological mechanism. We have no direct evidence on this issue because we have no measures of compliance. We know that the women participating in the study were not depressed to an extent that would impair their adherence to protocol, since that was an exclusion criterion, and we know that they complied with completing the annual forms and providing outcomes information about any hospitalizations. We also show that women with risk factors for cardiovascular disease, such as smoking, lack of physical activity, and being overweight, as well as women with hypertension, high cholesterol level, or diabetes, are . . . [Full Text of this Article]
AUTHOR INFORMATION
Sylvia Wassertheil-Smoller, PhD;
Aaron Aragaki, MS;
John Robbins, MD
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