Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study.
OBJECTIVE
The authors investigated the association between major depressive disorder, including its clinical course, and mortality from ischemic heart disease.


METHODS
This was a prospective cohort study of 8,261 men and 11,388 women 41-80 years of age who were free of clinical manifestations of heart disease and participated in the Norfolk, U.K., cohort of the European Prospective Investigation Into Cancer. The authors conducted a cross-sectional assessment of major depressive disorder during the period 1996-2000 and ascertained subsequent deaths from ischemic heart disease through linkage with data from the U.K. Office for National Statistics.


RESULTS
As of July 31, 2006, 274 deaths from ischemic heart disease were recorded over a total follow-up of 162,974 person-years (the median follow-up period was 8.5 years). Participants who had major depression during the year preceding baseline assessment were 2.7 times more likely to die from ischemic heart disease over the follow-up period than those who did not, independently of age, sex, smoking, systolic blood pressure, cholesterol, physical activity, body mass index, diabetes, social class, heavy alcohol use, and antidepressant medication use. This association remained after exclusion of the first 6 years of follow-up data. Consideration of measures of major depression history (including recency of onset, recurrence, chronicity, and age at first onset) revealed recency of onset to be associated most strongly with ischemic heart disease mortality.


CONCLUSIONS
Major depression was associated with an increased risk of ischemic heart disease mortality. The association was independent of established risk factors for ischemic heart disease and remained undiminished several years after the original assessment.
Surtees
Paul G
PG
Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK. paul.surtees@srl.cam.ac.uk
Wainwright
Nicholas W J
NW
Luben
Robert N
RN
Wareham
Nicholas J
NJ
Bingham
Sheila A
SA
Khaw
Kay-Tee
KT
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D006113:United Kingdom