Depression as a predictor of hospitalization due to coronary heart disease.

BACKGROUND

Studies have shown that patients with depression have higher rates of coronary heart disease (CHD) than people in the general population. However, large-scale population-based data on incidence rates of CHD in people with depression are needed. This study analyzed whether hospitalization for depression predicts CHD in men and women after accounting for socioeconomic status and geographic region.

METHODS

Data from the family coronary heart disease database at the Karolinska Institute, Stockholm, were used to identify all people in Sweden aged 25 to 64 at onset of depression and aged 25 to 79 at onset of nonfatal CHD during the study period (1987 to 2001). Standardized incidence ratios (SIRs) of CHD among those with and without depression were compared. All analyses were conducted in 2005.

RESULTS

There were 1767 cases of CHD among those with depression during the study period. The risk of developing CHD was strongest for those aged <40; the SIR was 2.17 (95% confidence interval [CI]=1.50-3.03). The risk was attenuated with increasing age in both men and women. People aged 70 to 79 at onset of depression did not have an increased risk of CHD.

CONCLUSIONS

Even after accounting for socioeconomic status and geographic region, depression is a clinically significant risk factor for developing CHD, especially in men and women aged 25 to 50. Primary healthcare teams should make particular efforts to identify young to middle-aged women and men who have depression, especially in combination with other CHD risk factors.