African Americans with symptoms of major depression are at an increased risk of stroke and coronary heart disease, according to research published in Circulation: Cardiovascular Quality and Outcomes.
Depression has been previously recognized as a consequence of stroke and coronary heart disease, however most studies have been conducted in white populations. In this study, researchers used data from the Jackson Heart Study (n=3,309) to assess associations of baseline depressive symptoms with incident stroke and coronary heart disease over 10 years in African Americans from Jackson, Miss.
Over 22% of participants with no stroke history and over 21% of participants with no history of coronary heart disease had depressive symptoms at baseline, including perceived stress, neuroticism, and life dissatisfaction. Those participants, who were more likely to be women, also had more chronic conditions, exercised less, smoked, had a higher BMI, and garnered lower wages than those without depressive symptoms.
Those with depressive symptoms had a 3.7% increased risk of stroke and 5.6% increased risk of coronary heart disease than those without depressive symptoms (2.6% and 3.6%, respectively). Differences persisted after adjustment for clinical and behavioral risk factors, but not after adjustment for coping strategies. In adjusted models, patients with depressive symptoms had a two-fold greater risk of stroke compared to those who did not have depressive symptoms (HR, 1.95; 95% CI, 1.02-3.71; P = .04).
“The need for greater understanding of associations between depressive symptoms and cardiovascular outcomes in African Americans is particularly important in light of reported racial disparities in disease severity, timely diagnosis, and use of drug therapy,” said researcher Emily O’Brien, PhD, of Duke University.
The study authors stress that better communication between patients and clinicians is needed in order to promote early screening and shared decision-making if depression is suspected.
- O’Brien EC, Greiner MA, Sims M, et al. Depressive Symptoms and Risk of Cardiovascular Events in African Americans: Findings From the Jackson Heart Study. Circ Cardiovasc Qual Outcomes. 2015; In press