Depression increases cardiovascular risk more in women than in men, finds study

Depression is the third leading cause of morbidity worldwide. Prior research showed that it is associated with a heightened risk of cardiovascular events, including myocardial infarction (MI), angina, stroke, and CV mortality. Women with depression showed a greater relative risk of developing heart-related negative health outcomes than men. Although there is little research on the evidence of sex differences in the impact of depression on heart health. 

“The identification of sex-specific factors in the adverse effects of depression on cardiovascular outcomes may help in the development of targeted prevention and treatment strategies that address the specific CVD risks faced by depressed patients,” said Hidehiro Kaneko, MD, assistant professor at the University of Tokyo in Japan and a corresponding author of the study. “A better understanding will allow healthcare providers to optimize care for both men and women with depression, leading to improved CVD outcomes for these populations.”

Researchers studied depression's connection to subsequent cardiovascular events in a cohort using the JMDC Claims Database from 2005 to 2022. They identified 4,125,720 participants meeting the criteria, with a median age of 44. Depression was diagnosed before the initial health checkup. The primary outcome included MI, angina, stroke, heart failure, and atrial fibrillation. Data collection involved BMI, blood pressure, and lab values. Statistical analysis compared clinical characteristics between participants with and without depression.

Results indicated that the hazard ratio of depression for CVD was 1.39 in men and 1.64 in women compared with participants without depression. Models also indicated that hazard ratios of depression for MI, angina, stroke, heart failure, and atrial fibrillation were higher for women than for men.

The study authors also highlighted that women may experience more severe and persistent symptoms, especially during hormonal changes like pregnancy or menopause. Additionally, women are more susceptible to traditional risk factors like hypertension, diabetes, and obesity when depressed, which can lead to cardiovascular disease.

“Our study found that the impact of sex differences on the association between depression and cardiovascular outcomes was consistent,” said Kaneko. “Healthcare professionals must recognize the important role of depression in the development of CVD and emphasize the importance of a comprehensive, patient-centered approach to its prevention and management. Assessing the risk of CVD in depressed patients and treating and preventing depression may lead to a decrease in CVD cases.”

References: Keitaro Senoo, Hidehiro Kaneko, Kensuke Ueno, Yuta Suzuki, Akira Okada, Katsuhito Fujiu, Taisuke Jo, Norifumi Takeda, Hiroyuki Morita, Kentaro Kamiya, Junya Ako, Koichi Node, Hideo Yasunaga, and Issei Komuro; Journal: Journal of the American College of Cardiology; DOI: 10.1016/j.jacasi.2023.11.015