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Depression may increase risk of stroke and stroke-related death

Sept. 20, 2011

By Maria Serraino

An analysis of 28 studies found that depression may be associated with an increased risk of having and even dying from a stroke. 

Strokes are a leading cause of death and permanent disability, and while depression is very common in the general population, studies that draw a link between the two have reported inconsistent results.   

An estimated 5.8 per cent of men and 9.5 per cent of women battle with a depressive episode in a 12 month period.  Depression has already been found to increase the risk of diabetes, high blood pressure and cardiovascular disease.

Researchers at the Harvard School of Public Health in Boston conducted a review and analysis of 28 cohort studies to determine if depression increases the risk of stroke.  Of the studies analyzed, there were a total of 317,540 participants and 8,478 stroke cases were reported during the followup periods ranging from two to 29 years. 

Depression was found to be associated with an increased risk for total stroke (45 per cent increase), fatal stroke (55 per cent increase) and ischemic stroke (25 per cent increase).  An increased risk for hemorrhagic stroke was not found.

Based on the most recent stroke statistics for the United States, per 100,000 individuals per year, there were an estimated 106 cases for total stroke, 53 for ischemic stroke and 22 for fatal stroke.  The researchers used risk estimates and concluded that approximately 3.9 per cent of stroke cases in the United States could be attributable to depression.

According to the researchers, depression may contribute to stroke in a variety of ways.  Depression has been linked to inflammation and can also affect the immune and neuroendocrine systems, all of which may influence stroke risk. Depression is also associated with poor health behaviours such as smoking, poor diet, lack of exercise and obesity.  Antidepressant medications could also contribute to stroke risk.  Depression is correlated with diabetes and hypertension, both of which are major risk factors of stroke.

The analysis by researchers provides strong evidence that depression is a significant risk factor for total stroke, fatal stroke and ischemic stroke. Because of the high prevalence of depression, the association has clinical and public health importance.

The study appears in the Journal of the American Medical Association on Sept. 21, 2011.  

 

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  • Women's College Hospital