THURSDAY, Aug. 11 (HealthDay News) -- Depressed women may be at
greater risk for stroke, new research suggests.
"We know that stroke can increase risk of depression, but depression itself may increase risk of future stroke," said study author An Pan, a research scientist at the Harvard School of Public Health in Boston.
"Depression is associated with hormonal changes in the body and affects chemicals in the brain, and we know that depression could be a marker for vascular disease," he said. "Depression is also associated with obesity, diabetes and hypertension, and people with depression are more likely to smoke and be physically inactive and not take their medication regularly."
Women with a history of depression were 29 percent more likely
to have a stroke during six years of follow-up, and this finding
held even when researchers controlled for other factors known to
increase stroke risk. What's more, women who took antidepressants
had a 39 percent increased risk of stroke.
The study was published online Aug. 11 in the journal
The jury is out in terms of the role that antidepressants have
in upping stroke risk, Pan said. "We don't know whether medications
increase risk of stroke or if medicine is a marker for severity of
Depressed women were more likely to be single, smoke and be less
physically active than their non-depressed counterparts, the study
showed. They were also slightly younger, had a higher body mass
index and more coexisting conditions such as high blood pressure,
heart disease and diabetes.
Pan and colleagues followed 80,574 women aged 54 to 79 who took
part in the Nurses' Health Study from 2000 to 2006 and had no prior
history of stroke. Depression was assessed via a standardized tool
measuring symptoms, antidepressant prescriptions, and/or a
diagnosis of depression from a doctor. Overall, 22 percent of women
were depressed or had a history of depression when the study began,
and there were 1,033 strokes during six years of follow-up.
Specifically, 538 women had ischemic stroke, the most common form
of stroke, which is caused by a blockage such as a blood clot, and
124 women had hemorrhagic or bleeding stroke, which occurs when a
blood vessel in the brain bursts.
"If you have depression, see a doctor and get diagnosed," he said. "Treating your depression is very important to lower your future risk of cardiovascular disease, and if you have depression, you probably have some other lifestyle factors that you need to change."
Dr. Alan Manevitz, a psychiatrist at Lenox Hill Hospital in New
York City, agreed. "Depression is associated with poor health
behaviors including poor diet, lack of medication compliance and
lack of exercise, all of which can increase stroke risk."
Depression can also cause biological changes that may increase
risk for stroke, and may be a warning sign of stroke, he said. Many
of the same lifestyle changes that help treat depression will also
lower risk for stroke such as eating a healthy diet, engaging in
regular physical activity, sleeping well and not smoking, he
Dr. Cathy Sila, director of the Stroke & Cerebrovascular
Center at University Hospitals Case Medical Center in Cleveland,
called the findings "provocative." The study only looked at women,
but the findings likely apply to men as well, she added.
Sila said that more research is needed to better understand the
relationship between stroke and depression. "There are important
differences between depressed women and non-depressed women," she
said. "Women who are depressed are more likely to have diabetes,
hypertension and high cholesterol, be overweight and sedentary, all
of which are known to increase risk for stroke."
Lifestyle changes can help lower stroke risk, but it is tough to
make these changes when you are depressed, she said. "We need to
understand how depression works against people making the type of
changes they need to make," she said. "This study opens up a whole
host of questions."
Learn more about depression at the
U.S National Institute of Mental Health.