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Study links depression with increased stroke risk in women

August 11, 2011

By Patricia Nicholson

New research suggests that older women who are depressed may have higher risk of stroke than women with no history of depression.

Researchers at Harvard Medical School and Harvard School of Public Health followed more than 80,000 women ages 54 to 79 (average age 66) who were participating in the Nurses’ Health Study. None of the women had a history of stroke. During six years of followup, 1,033 women had strokes. The researchers found that the women with depression or a history of depression had a 29 per cent higher stroke risk than women without depression.

The study used three criteria for depression: a diagnosis of depression from a doctor, use of antidepressants, or a score indicating depression on the mental health assessments that the study participants completed several times during the study period. Women with any of these criteria were classified as depressed or having a history of depression.

Further analysis showed that stroke risk was 41 per cent increased in women who were currently depressed compared to women with no depression, but the increased risk for women who had been depressed in the past was not significant.

However, women who took antidepressants had a higher stroke risk even if they did not currently have depression symptoms or a diagnosis of depression. Women taking antidepressants who currently had symptoms had a 39 per cent higher risk of stroke compared to women with no history of depression, while the increased risk for women on antidepressants with no current symptoms was 31 per cent.

When different types of antidepressants were analyzed, the researchers found that increased stroke risk applied to selective serotonin reuptake inhibitors (SSRIs, the most popular type of antidepressant), and not to other types.

The study authors note that SSRIs themselves may not increase stroke risk, but may be an indicator of more severe depression.

Several possible reasons for a link between depression and stroke are offered in the study. These include the effect of depression on several systems that affect stroke risk, including inflammatory effects, interaction between the nervous system and glands that produce hormones (the neuroendocrine system), and possible effects on the blood vessels. Depression may also influence lifestyle factors that can increase stroke risk, such as poor diet, being inactive and smoking.

The study results suggest that older women who are depressed have an increased risk of stroke. This finding is significant because depression is common in older women, and stroke risk is also higher in this group.

The study was published online in the journal Stroke on Aug. 11, 2011.

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  • A publication of:
  • Women's College Hospital