A prospective analysis of the association between cardiovascular disease and depression in middle-aged women

OBJECTIVE: Experimental and clinical data demonstrate a close association between depression and coronary heart disease (CHD). Because no simple depression instrument for use by general practitioners has been shown to predict CHD, the objective of this study was to evaluate whether such a questionnaire could predict CHD. METHODS: The prevalence of CHD and CHD risk factors was assessed in women with depression, measured by a validated three-question depression screening instrument. Among 1,919 participants in the breast arterial calcification and CHD 5-year prospective study, 1,454 women (75.8%) completed a baseline depression inventory. RESULTS: Among the 1,454 women, 72.2% were postmenopausal, and the mean (SD) age at the conclusion of a 5-year prospective study was 61.3 (12.1) years. Among the women with no CHD risk factors at baseline and with one or less positive depression responses compared with those with two or more, 1.6% versus 3.8%, respectively, had at least one CHD risk factor (P = 0.004) by the 5th year of the study. In addition, 2.3% versus 6.0%, respectively, developed CHD (P = 0.005) by the 5th year of the study. Among all women with no positive depression responses compared with those with any positive depression responses, 2.1% versus 5.6%, respectively, had developed CHD by the 5th year of the study (P = 0.002). Finally, more positive depression responses were associated with a greater prevalence of CHD. CONCLUSIONS: In this prospective study, depression-detected by a validated three-item questionnaire-was able to predict those women more likely to develop CHD.