Impact of depression on cardiovascular disease risk based on gender | Image credit: © zinkevych – © zinkevych – Stock.adobe.com.

Both men and women with depression are at increased risk of cardiovascular disease (CVD), but women are at higher risk, a new study has found.¹

“Our study found that the influence of gender differences on the association between depression and cardiovascular disease was consistent,” researcher Hidehiro Kaneko, MD, PhD, assistant professor at the University of Tokyo, said in a press release. .²

Cardiovascular disease particularly affects women, accounting for 35% of women’s deaths each year.³ This is more common than cancer deaths, heart attacks, and strokes, even though society believes these diseases more often affect men.

Cardiovascular disease in women remains “understudied, underdiagnosed, and undertreated,” according to a 2021 study published in The Lancet. Gaps in knowledge exist and impact treatment.^Four Some health care workers aren’t trained enough to identify the symptoms of a heart attack in women.³ Some women experience no symptoms before a heart attack, while others experience angina. Pain in the neck, jaw, and throat. Pain in the upper abdomen or back. Nausea; vomiting; and fatigue.

Among many other conditions, depression acts as a risk factor for cardiovascular disease, and according to the Anxiety and Depression Association of America, women are two to three times more likely to be clinically depressed than men. It is said to be expensive. Many social factors can cause depression in women, from stress related to work and family responsibilities to societal expectations.

Researchers led by Keitaro Seno, MD, of Kyoto Prefectural University of Medicine in Japan, conducted an observational cohort study to assess the association between depression and CVD, providing insight into potential mechanisms contributing to gender differences. How to prevent and manage her CVD according to gender-specific factors.

“A better understanding will allow healthcare providers to optimize care for both men and women with depression, leading to improved CVD outcomes in these populations,” Professor Kaneko said.²

The team leveraged data from the JMDC claims database (a combination of Japan’s health examination database and administrative claims data) from 2005 to 2022 to identify 4,125,720 participants who met the criteria. The study included 2,370,986 men with a median age of 44 years (36-52 years).

The researchers collected data on body mass index (BMI), blood pressure, and fasting test values ​​during the initial health check. They wanted to assess MI, angina, stroke, heart failure (HF), and atrial fibrillation (AF).

In this sample, 4.2% of male participants and 4.5% of female participants had depression.¹

Finally, women had a higher hazard ratio of depression for CVD than men (1.64; 95% confidence interval) [CI]1.59 – 1.70 vs. 1.39; 95% CI, 1.35 – 1.42; P < .001). Additionally, the model demonstrated that the hazard ratios for depression for myocardial infarction, angina, stroke, heart failure, and atrial fibrillation were greater in women than in men.

Researchers highlighted why depression has a greater impact on heart health in women than in men. They explained that women may face more severe and persistent symptoms of depression than men. Additionally, women may be at increased risk of depression during key hormonal changes such as pregnancy and menopause.

Additionally, women are more exposed to risk factors such as hypertension, diabetes, and obesity when depressed, all of which can contribute to the development of cardiovascular disease. Additionally, the researchers suggested that differences in medical treatment, genetics and hormonal profiles between men and women may increase women’s risk of cardiovascular disease.

Researchers concluded that they could not establish a direct causal relationship between depression and CVD events, could not determine the severity or duration of depression symptoms, and that other potential factors such as socioeconomic status and COVID-19 infection They highlighted several limitations, including the failure to take into account confounding factors.

“Medical professionals need to 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,” said Kaneko.² “Assessing the risk of CVD in patients with depression and treating and preventing depression may lead to a reduction in CVD cases.”

References

1. Kazuya Seno, Hiroshi Kaneko, Kazuya Ueno, et al. Gender differences in the association between depression and the development of cardiovascular disease. Journal of the American College of Cardiology. 2024.
2. Women with depression have a higher cardiovascular risk than men. Yurek Alert! March 12, 2024. https://www.eurekalert.org/news-releases/1036966. Accessed March 11, 2024.
3. Depression and the heart: Understanding cardiovascular risk factors in women. RTI Health Advance. February 22, 2023. https://healthcare.rti.org/insights/heart-disease-and-depression-in-women#:~:text=The%20AHA%20study%20noted%20that,more%20likely%20than% 20men%20to. Accessed March 11, 2024.
4. Vogel B, Acevedo M, Appelman Y et al. Lancet Committee on Women and Cardiovascular Disease: Reducing the global burden by 2030. lancet. 2021;397(10292):2385-2438. doi:10.1016/S0140-6736(21)00684-X