Depression poses a risk for cardiovascular diseases in men that is just as great as that posed by high cholesterol levels and obesity. Researchers from the Technical University of Munich (TUM), the Helmholtz Zentrum München and the German Center for Cardiovascular Disease (DZHK) have compared depression to the five most common risk factors. Based on their results they advocate new standard diagnoses for high risk patients.
According to the World Health Organisation WHO, 350 million people worldwide are affected by depression. But the mental state is not all that is affected: depression can also compromise the body. “Today there is little doubt that depression is a risk factor for cardiovascular diseases,” explains Karl-Heinz Ladwig. He is group leader at the Institute of Epidemiology II at the Helmholtz Zentrum München, professor of psychosomatic medicine at TUM's Klinikum rechts der Isar as well as scientist of DZHK. "The question now is: What is the relationship between depression and other risk factors like tobacco smoke, high cholesterol levels, obesity or hypertension – how big a role does each factor play?"
In order to examine this question, Ladwig and his team analyzed data from 3,428 male patients between the ages of 45 and 74 years and observed their development over a period of ten years. “The work is based on a prospective population-based data set from the MONICA/KORA-Study that, with a total term of up to 25 years, is one of the few large studies in Europe that allows such an analysis,” reports the statistician Dr. Jens Baumert of Helmholtz Zentrum München, who was also involved in the publication.
“Investigate depression in high-risk patients”
In their analyses, the scientists compared the impact of depression with the five major risk factors high cholesterol levels, obesity, high blood pressure, smoking and diabetes. The results are published in the journal ‘Atherosclerosis’. “Our investigation shows that the risk of a fatal cardiovascular disease due to depression is almost as great as that due to elevated cholesterol levels or obesity,” Ladwig summarizes.
Viewed across the male population, a depressive disorder had been diagnosed in roughly 15 percent of the cardiovascular deaths. For obesity and diabetes, this number is below 10 percent, for smoking it is around 17 percent. The one factor that figures in considerably higher is high blood pressure with almost 30 percent.
“We invested a great deal of time in this work, starting with the long observation period,” says study leader Ladwig. But the effort paid off: “Our data show that depression has a medium effect size within the range of major, non-congenital risk factors for cardiovascular diseases.” Ladwig accordingly proposes consequences: “In high risk patients, the diagnostic investigation of co-morbid depression should be a standard procedure. This could be registered with simple means.”
Ladwig, KH. et al. (2016): Room for depressed and exhausted mood as a risk predictor for all-cause and cardiovascular mortality beyond the contribution of the classical somatic risk factors in men. Atherosclerosis, doi: 10.1016/j.atherosclerosis.2016.12.003
Prof. Dr. Karl-Heinz Ladwig
Technische Universität München
Klinikum rechts der Isar
Klinik für Psychosomatische Medizin und Psychotherapie
Tel. +49 89 3187 3623