Women, diagnosed with depression, are more at risk for developing heart disease than men. The term heart disease of course is broad and could include heart attacks, strokes, heart failure, and atrial fibrillation.
An estimated 60 million women in the United States have heart disease, and they are approximately twice as likely as men to develop depression.
In the new study, published in the journal JACC: Asia, researchers emphasized how important it is for cardiologists to screen for depression in their patients.
Dr. Hidehiro Kaneko, an assistant professor at the University of Tokyo in Japan and one of the researchers involved in the study, has emphasized that a better understanding of the patient’s history may help healthcare providers improve the quality of care for depressed patients, both women, and men, which allows for better control of heart disease outcomes.
Study Details
The study analyzed medical claims between 2005 and 2022 and also the rates of depression and heart disease diagnoses in nearly 4 million patients.
The number of men in the experiment was slightly greater than the number of women. The average age of patients was about 44 years.
One of the analysis criteria was that patients must have a clinical diagnosis of depression before being diagnosed with heart disease.
The health information included for patients was body mass index, blood pressure, fasting cholesterol level, and blood sugar levels.
Cases of cardiovascular disease include myocardial infarction (heart attack), angina (recurrent chest pain), heart failure, and atrial fibrillation.
The researchers used the data to calculate a range of risk ratios for women versus men — simply the risk of something happening.
The results indicated that the risk of a diagnosis of depression leading to cardiovascular disease was 1.39 in men and 1.64 in women.
The rates of diagnosis of depression that increased the risk of heart attacks, chest pain, angina, and heart failure were greater in women than in men.
The study had obvious limitations; for example, the research team was unable to collect more accurate information and details about the symptoms of depression in participants or the potential impact of the Coronavirus COVID-19.
Another limitation is that the study is observational only, which means it is unable to prove a link between depression and cardiovascular disease.
Heart Attacks In Women
The risk of heart attacks is equal between the sexes, however, women are less likely than men to receive treatment and die from a heart attack, according to study statistics.
Dr. Evelina Grayver, a cardiologist and director of Women’s Heart Health at Central Region Northwell Health, said that she is very excited that there is finally research conducted for this field of study.
She added that cardiovascular disease is the number one cause of death in women and that it kills more women than breast, lung, and colon cancers combined, and many women do not take their symptoms into account because they do not resemble the symptoms of a typical heart attack.
Grayver noted that women may experience chest tightness, shortness of breath, fatigue, and abdominal pain, rather than what men typically experience pain in the left arm or the feeling of something heavy pressing on the chest.
The American Heart Association reported in previous research that the probability of death in women increases by about 20% within the first 5 years of having a severe heart attack. In hospitals, women are less likely to see a cardiologist and are less likely to receive a prescription for cholesterol medications and beta blockers.
Depression In Women
Women are twice as likely to suffer from depression as men, but why?
The researchers in the new study hypothesize that women may experience more severe and persistent symptoms, and the increasing severity and persistence of these symptoms may affect their lifestyle and habits, which contributes to raising the risk of heart attacks.
Women also face more unique medical challenges than men, including pregnancy and menopause. These hormonal fluctuations easily play a role in health and psychological problems such as depression, anxiety, and general stress.
Women also have much higher rates of metabolic syndrome, which includes typical risk factors for cardiovascular disease, such as high blood pressure, diabetes, and obesity.
Depression & Heart Disease
Dr Grever said that the effort that went into the study to understand why women have a higher risk of cardiovascular disease and why depression increases the risk should be appreciated.
Grever highlighted two contributing factors to why women suffer longer and more severe periods of depression; inflammation and hormonal changes.
She added that depression and anxiety cause inflammatory chaos in the body. Inflammation causes a significant increase in both cortisol levels in the body and a cascade of inflammatory events, which affects the blood vessels.
The cardiovascular system is not limited to the heart only but extends to include all vessels, starting from the carotid artery in the neck down to the heart and passing through the vessels of the entire body.
Chronic stress, depression, and anxiety can perpetuate inflammation, causing the hardening of blood vessels and a higher risk of plaques and clots.
Grever continued her explanation by saying that everyone knows that women with depression have a greater risk of obesity and diabetes, in addition to the presence of more important risk factors, especially gender.
Women should be treated in accordance with their reproductive stage, the probability of women experiencing depression during their fertile years differs from those in peri-menopause, menopause, or post-menopause stages.
Grever noted that the hormonal changes that women experience during menopause greatly affect their psychological and cardiovascular health. Estrogen is known for its benefits in relaxing blood vessels and stimulating the production of good cholesterol (known as HDL).
She said it is very common for women to suffer from anxiety and depression disorders during these periods. This is a result of the disappearance of the protection that estrogen provides to the heart, in addition to the increase in hormonal changes affecting their mental health.
Patients must be fully examined when visiting the hospital, even if they go to the cardiology department, and every specialist doctor must also have tools to evaluate and diagnose depression… Doctors still have to treat and diagnose people as a whole and not hesitate to talk about mental health.