Women who suffer from depression are at higher cardiovascular risk than men

Women who suffer from depression are at higher cardiovascular risk than men

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OfCristina Marrone

Hormonal changes and the severity of depressive symptoms may underlie the mechanisms that make women more susceptible to cardiovascular events

People who suffer from depression face a greater risk of cardiovascular diseases such as heart attack, stroke, angina. According to one recent researchwhich confirms the previous ones, the risk of cardiovascular disease it is approximately 72% higher among people with major depressive disorders compared to healthy peers. It is in fact known that in the presence of a depressive disorder some changes physiological functions: increases the cortisol in circulation, the sympathetic system is hyperactive and increases the release of catecholamines (norepinephrine and serotonin) which induce tachycardia and alterations in heart rate with the risk of arrhythmias and thrombosis.

All these consequences would be more pressing for women. A new Japanese study published by the American Institute of Cardiology concludes that more women than men suffer from cardiovascular disease (and suffer negative outcomes) following a diagnosis of depression and scientists have tried to investigate the mechanisms underlying basis of these differences.

How the study was conducted

The researchers of this latest work evaluated theassociation between depression and subsequent cardiovascular events with an observational study. Insurance company claims databases were used and over 4 million participants who met the study criteria were identified. The average age was 44 years and 2,370,986 were men. Depression was diagnosed before the initial health check. Using standardized protocols, the researchers collected body mass index (BMI), blood pressure and fasting blood values. The statistical significance of clinical differences between participants with and without depression was then analyzed. Models indicate that the relationship between depression and cardiovascular disease is higher among women.

Because women are more at risk

The authors of the study initiated a discussion to investigate the potential mechanisms underlying why depression appears to have a greater impact on heart health of women compared to men. One suggested explanation is that women could demonstrate more severe and persistent symptoms of depression than men and may be more likely to suffer from depression during critical periods of hormonal changessuch as pregnancy or menopause. Furthermore, women appear to be more susceptible to traditional risk factors when they are depressed, such as hypertension, diabetes, obesity which can contribute to the development of cardiovascular diseases.

Why it is important to treat depression

“Our study found that the impact of sex differences on the association between depression and cardiovascular outcomes was consistent,” commented Hidehiro Kaneko, assistant professor at the University of Los Angeles and the University of Tokyo, one of the authors of the study . «A better understanding of the mechanisms will allow healthcare professionals to recognize what is important role of depression in the development of cardiovascular disease and the importance of a comprehensive patient-centered and prevention approach. Assessing the risk of cardiovascular disease in depressed patients and treating and preventing depression may lead to a decrease in cases of cardiovascular disease.”

The study has limitations, as underlined by the authors themselves. A direct causality between depression and cardiovascular events has not been established and the duration and severity of six depressive symptoms have not been assessed. Finally, potential confounding factors that could influence the association between depression and cardiovascular diseases such as socioeconomic status or Covid disease were not taken into consideration.

March 13, 2024

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