Depression and risk of stroke: a meta-analysis of prospective studies.
OBJECTIVE
A history of depression may be associated with an increased risk of stroke. We aimed to determine the association between depression and risk of stroke by performing a meta-analysis of prospective studies.


METHODS
Relevant studies were identified by a PubMed database search through May 2011 without restrictions and by reviewing reference lists of obtained articles. Community-based or population-based prospective studies that reported relative risk estimates with 95% confidence intervals for the association between depression and stroke were selected. Studies that enrolled participants with preexisting stroke at baseline were excluded. A random-effects model was used to compute the pooled risk estimate.


RESULTS
Random-effects meta-analysis of 17 prospective studies involving 206 641 participants and 6086 cases demonstrated a significant positive association between depression and subsequent risk of stroke (pooled relative risk, 1.34; 95% confidence interval, 1.17-1.54) after adjustment for potential confounding factors. The associations were similar between men and women. Potential publication bias may exist, but correction for this bias using a formal statistical method did not materially alter the combined risk estimate.


CONCLUSIONS
Depression significantly increased the risk of development of stroke, and this increase was probably independent of other risk factors, including hypertension and diabetes.
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou, 215123 China. qinliqiang@suda.edu.cn
Jia-Yi
JY
Dong
Yong-Hong
YH
Zhang
Jian
J
Tong
Li-Qiang
LQ
Qin
D003863:Depression / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D020521:Stroke / Q000209:etiology*