MedicalResearch: What are the main findings of the study?
Dr. Shah: We discovered that in a group of patients who were undergoing heart evaluation with coronary angiography, symptoms of depression predicted increased risk of coronary artery disease and death in women aged 55 years or less. This relationship was stronger in these women than older women, as well as in men aged 55 years or less. Over 1 in 4 women aged 55 years or less had moderate to severe depression, which was higher than any other group; these women had over twice the risk of having heart disease or dying over the next 3 years compared to those with none or mild depression.
MedicalResearch: Were any of the findings unexpected?
Dr. Shah: We were impressed with how consistent the findings were; that these young, depressed women both had more coronary artery disease and risk of death, while older women and younger men did not have these associations with depression. We also found that depressed men aged 65 or older had increased risk of death compared to those without depression, which was somewhat surprising. Finally, we were surprised that the increased risk of coronary artery disease in these young, depressed women did not explain their increased risk of death.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Shah: Clinicians should view depression as a risk factor for heart disease in young women alongside with smoking and diabetes. Psychiatrists may, in light of this, recommend lifestyle changes that may also have emotional benefits such as exercise. Other clinicians may consider discussing depression when surveying patients for heart disease risk factors. The American Heart Association recently released a statement suggesting that depression be recognized as a risk factors similar to other traditional risk factors.
MedicalResearch: What recommendations do you have for a future study as a result of this study?
Dr. Shah: As the next step, it is important to do studies that evaluate the social and biological reasons behind these findings, as this could help figure out the best way to prevent future deaths. In our lab, we are evaluating the biological effects of sudden stress in young women who have suffered from heart attacks, and comparing them to similarly aged men with recent heart attacks. Other clinical trials should also be done with various depression treatments, including antidepressants, which are commonly used but need more research to evaluate safety and efficacy in such high risk patients.
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