People with depression face an increased risk of cardiovascular disease (CVD). However, more women than men experience cardiovascular disease after being diagnosed with depression, according to a new study published today. JACC: Asia. This study investigates the relationship between depression and CVD, sheds light on potential mechanisms contributing to gender differences, and highlights the importance of tailoring CVD prevention and management strategies according to gender-specific factors. I’m emphasizing.

Depression is the third most common cause of illness worldwide. Previous studies have shown that it is associated with an increased risk of cardiovascular events, including myocardial infarction (MI), angina, stroke, and CV death. Women with depression have a higher relative risk of developing negative heart-related health outcomes than men, but the evidence for gender differences in the impact of depression on heart health remains controversial, and the underlying mechanisms remain controversial. Not fully understood.

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

Researchers in this study assessed the association between depression and subsequent CVD events by conducting an observational cohort study using the JMDC claims database between 2005 and 2022. They identified 4,125,720 participants who met the study’s criteria. The median age was 44 years (36-52 years), and 2,370,986 participants were male. Depression is defined as clinically diagnosed before the first medical examination.

The study used a standardized protocol to collect participants’ body mass index (BMI), blood pressure, and fasting laboratory values ​​during an initial physical examination. The primary endpoint was a composite endpoint including MI, angina, stroke, heart failure (HF), and atrial fibrillation (AF).

The researchers analyzed the statistical significance of differences in clinical characteristics between participants with and without depression. Results show that compared to participants without depression, the hazard ratio for depression due to CVD was 1.39 in men and 1.64 in women. The model also shows that the hazard ratios for myocardial infarction, angina pectoris, stroke, heart failure, and depression for atrial fibrillation are higher in women than in men.

The study authors highlight an important debate regarding potential mechanisms that may contribute to why depression affects heart health in women more than in men. One explanation is that women may experience more severe and persistent symptoms of depression than men, and may be more likely to become depressed during critical periods of hormonal changes such as pregnancy and menopause. That means there is.

Other mechanisms include that women are more susceptible to traditional risk factors such as hypertension, diabetes, and obesity when depressed, which may contribute to the development of CVD . Differences in health care utilization and treatment between men and women, as well as sex-specific differences in biological factors such as genetics and hormonal profiles, may also increase CVD risk in women.

“Our study found that the influence of gender differences on the association between depression and cardiovascular disease is consistent,” Professor Kaneko said. “Health care 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 risk and treating and preventing depression may lead to fewer CVD cases.”

Limitations of this study include the inability to establish a direct causal relationship between depression and cardiovascular events and the inability to accurately reflect the severity or duration of depressive symptoms. Potential confounders that could influence the association between depression and CVD, such as socio-economic status, were not considered. Researchers also acknowledged that COVID-19 infection may have been a confounding factor.

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