Depression Impacts Women's Hearts More Than Men's, Study Finds

Depression is known to have a negative impact on heart health, but new research has found that these effects may be more pronounced for women than men.

While all people with depression face a heightened risk of cardiovascular disease (CVD), women with a depression diagnosis develop CVD more often than men do, according to a new study.

Published in JACC: Asia on Tuesday, the study examines the link between CVD and depression and explores sex differences in risk levels.

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Researchers conducted the observational cohort study using the JMDC Claims Database between 2005 and 2022, identifying 4,125,720 eligible participants without a history of cardiovascular disease. Of the participants, 1,754,734 were women, and 2,370,986 were men, with a median age of 44 years old.

The researchers collected participants’ body mass index (BMI), blood pressure, and fasting laboratory values at an initial health checkup and then followed up with participants for roughly 1,288 days to assess the association between depression and subsequent CVD events. This includes myocardial infarction (MI), angina pectoris, stroke, heart failure (HF), and atrial fibrillation (AF).

The researchers found a significant association between depression and subsequent CVD events in both men and women, with a stronger association observed in women. Compared with participants without depression, the hazard ratio of depression for CVD was 1.39 in men and 1.64 in women, and hazard ratios of depression for MI, angina pectoris, stroke, HF, and AF were also higher for women than for men.

The authors point to several potential explanations for the increased risk level in women, including that women may experience more severe and persistent symptoms of depression compared with men and that women may be more likely to experience depression during critical periods of hormonal changes, such as during pregnancy or menopause — both of which could lead to greater impacts on cardiovascular health.

Studies have also shown that women with depression may be more likely to have traditional cardiovascular risk factors, such as hypertension, diabetes, and obesity, compared with men with depression, which may contribute to the development of CVD and could potentially exacerbate the adverse effects of depression on cardiovascular health in women.

Women are also more likely to seek health care services and may be more likely to be diagnosed with depression than men, but women with depression may be less likely to receive appropriate treatment for their condition. This, the authors said, highlights the importance of early detection and appropriate treatment of depression in women to help reduce the risk of CVD.

Finally, sex-specific differences in biological factors, such as genetics and hormonal profiles, may likewise contribute to the sex difference in the association between depression and CVD, the authors said.

“The identification of sex-specific factors in the adverse effects of depression on cardiovascular outcomes may help in the development of targeted prevention and treatment strategies that address the specific CVD risks faced by depressed patients,” said Hidehiro Kaneko, M.D., an assistant professor at the University of Tokyo and a corresponding author of the study, in a news release. “A better understanding will allow healthcare providers to optimize care for both men and women with depression, leading to improved CVD outcomes for these populations.”

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