title: Depression risk in patients with coronary heart disease in Germany.
abstract: OBJECTIVE
  To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices.
  
  
  METHODS
  Longitudinal data from nationwide general practices in Germany (n= 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1:1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders.
  
  
  RESULTS
  Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9% of patients were men. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression (P< 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95%CI: 1.49-1.59,P< 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively.
  
  
  CONCLUSIONS
  The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.
authors.affiliation: Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Konrad
authors.affiliation: Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany.
authors.forename: Louis
authors.initials: L
authors.lastname: Jacob
authors.affiliation: Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapp
authors.affiliation: Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany.
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
keywords: Coronary heart disease; Depression; Primary care; Quality of life; Risk factors