Young women are more prone to depression than older women or men of any age. New research looked into whether depression was a sign of physical health problems.
A recent study found that women aged 55 years old and younger were twice as likely to have a heart attack, die from heart disease or require artery-opening surgeries if they had been diagnosed with depression.
The researchers suggested that healthcare providers and patients, especially younger women, need to take depression very seriously.
The lead author of this study was Amit J. Shah, MD, MSCR, from the Departments of Epidemiology and Medicine at Emory University in Atlanta, Georgia and the Department of Medicine at the Atlanta Veterans Affairs Medical Center in Decatur, Georgia.
The study included 3,237 patients who underwent coronary angiography to see if they had coronary artery disease (CAD) between 2003 and 2010 at three Emory healthcare sites.
Coronary angiography is a test that uses dyes and special X-rays to look at the inside of the coronary arteries.
The coronary arteries supply oxygenated blood to the heart, and CAD is defined by narrowing of the coronary arteries.
In this study, 34 percent of the participants were women, and the average age of the whole study population was 63 years old.
The researchers evaluated depressive symptoms via the Patient Health Questionnaire (PHQ-9). Each of the nine questions is about a depressive symptom, and the participants could rate the level of severity or frequency of each symptom from 1 to 3. The highest possible total score is 27. The researchers considered a participant to have moderate to severe depression if they scored a 10 or higher and to have mild or no depression if they scored less than a 10.
Presence of CAD was determined by looking at the angiographies.
Follow-up was conducted at two to five years after enrollment.
The findings showed that among the women who were 55 years old and younger, each one-point increase in the depressive symptoms score was associated with a 7 percent increase in the likelihood of CAD.
Depressive symptoms were not associated with an increased risk of CAD in the men and women older than 55 years.
The researchers discovered that the women 55 years old and younger were 2.7 times more likely to have a heart attack, die from heart disease or need artery-opening surgery during follow-up if they had moderate to severe depression.
In addition, the women aged 55 years and younger were 2.45 more likely to die due to any cause during follow-up if hey had moderate to severe depression.
"Women in this age group are also more likely to have depression, so this may be one of the 'hidden' risk factors that can help explain why women die at a disproportionately higher rate than men after a heart attack," Dr. Shah said in a press statement.
The researchers also believe that healthcare providers should ask more questions and be aware that younger women are more vulnerable than others to depression.
In 2008, the American Heart Association issued a scientific statement recommending that depression be formally considered a risk factor of heart disease on the same level as other heart disease risk factors like diabetes and high blood pressure.
This study was limited because all of the participants came from Emory healthcare sites, so the findings may not be generalizable outside the study population.
Also, women with CAD and depression might have been over-represented in the study population, and all the data were cross-sectional, so the researchers could not determine a cause-and-effect relationship between depression and CAD.
This study was published on June 18 in the Journal of the American Heart Association.
The National Institutes of Health, the National Center for Advancing Translational Sciences and the Emory Heart and Vascular Institute provided funding.