Depression as a risk factor for ischaemic heart disease in men: population based case-control study.
OBJECTIVE
To determine the relation between depression, anxiety, and use of antidepressants and the onset of ischaemic heart disease.


METHODS
Population based case-control study.


METHODS
All 5623 patients registered with one general practice.


METHODS
188 male cases with ischaemic heart disease matched by age to 485 male controls without ischaemic heart disease; 139 female cases with ischaemic heart disease matched by age to 412 female controls.


METHODS
Adjusted odds ratios calculated by conditional logistic regression.


RESULTS
The risk of ischaemic heart disease was three times higher among men with a recorded diagnosis of depression than among controls of the same age (odds ratio 3.09; 95% confidence interval 1.33 to 7.21; P=0.009). This association persisted when smoking status, diabetes, hypertension, and underprivileged area (UPA(8)) score were included in a multivariate model (adjusted 2.75; 1.13 to 6.69; P=0.03). Men with depression within the preceding 10 years were three times more likely to develop ischaemic heart disease than were the controls (3.13; 1.27 to 7.70; P=0.01). Men with ischaemic heart disease had a higher risk of subsequent depression [corrected] than men without ischaemic heart disease (adjusted 2.34; 1.34 to 4.10; P=0.003). Depression was not a risk factor for ischaemic heart disease in women on multivariate analysis (adjusted 1.34; 0.70 to 2.56; P=0.38). Anxiety and subsequent ischaemic heart disease were not significantly associated in men or women.


CONCLUSIONS
Depression may be an independent risk factor for ischaemic heart disease in men, but not in women.
Hippisley-Cox
J
J
Department of General Practice, The Medical School, Queen's Medical Centre, Nottingham NG7 2UH. julia.h-cox@nottingham.ac.uk
Fielding
K
K
Pringle
M
M
D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001007:Anxiety / Q000150:complications; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000523:psychology*; D012307:Risk Factors; D013997:Time Factors
D000929:Antidepressive Agents, Tricyclic