Two recent studies suggest that depression, when diagnosed in young women, may be associated with elevated risk of heart disease later in life.
This is concerning for several reasons.
First, depression and heart disease are two of the most prevalent pathologies in the world.
Second, women are far more likely than men to have a depressive disorder. While heart disease is more common among men, the gender gap is shrinking rapidly.
Finally, cardiovascular disease (CVD) is the world’s leading cause of death. It accounts for an average of about 17.9 million deaths annually. In the United States, CVD has been the leading cause of death every year since 1921.
Establishing a connection between depression and heart disease could help healthcare professionals identify patients at greatest risk. It could also encourage women with depression to get professional help, even if they believe they can manage symptoms on their own.
The Scope of the Problem
Let’s take a look at the prevalence of depression and heart disease among women, starting with depression.
Women and Depression
On both the national and global levels, depression is more common among women than men:
- In 2021, the National Institute of Mental Health (NIMH) reported that the past year prevalence of major depressive disorder was 3% among adult women and 6.2% among adult men.
- A 2017 meta-analysis found that the global rate of major depressive disorder was 3% among women and 3.5% among men.
- These two reports indicate that women are 1.5 to 1.7 times more likely than men to develop major depressive disorder.
Gender bias may skew this data somewhat, as studies show that women are more likely than men to receive referrals to psychiatric services instead of medical treatment when reporting equal levels of pain.
However, we have to pay attention to the data, which indicates that tens of millions of women throughout the world live with a depressive disorder.
Heart Disease and Women
Across the globe, no health condition presents a greater danger to women than cardiovascular disease. For example:
- Heart disease is the number one killer of women in the United States.
- In 2021 alone, more than 330,000 women in the U.S. died of CVD. This represents about 20% of all deaths involving women that year.
- Together, heart disease and stroke are responsible for about one in every three deaths among women.
- Globally, cardiovascular disease kills 13 times more women than breast cancer.
- Heart disease and stroke kill more women every year than do all types of cancer
The good news, according to the World Heart Federation (WHF), is that people could prevent about 80 percent of all cardiovascular deaths by incorporating a few habits into their daily lives.
The not-so-good news is that only about 44 percent of women recognize that heart problems pose such a significant threat to their health, and only about half can correctly identify the symptoms of a heart attack.
The Link Between Depression & Heart Disease
The statistics clearly show that depression and heart disease pose significant health challenges for women. Research suggests the link between the two conditions may be stronger than experts previously realized.
On April 6, 2024, Cardiologist Giovanni Civieri, MD, presented a study on this link at the American College of Cardiology Annual Scientific Session.
Civieri conducted a 10-year study that analyzed health records from more than 71,000 participants in the Mass General Brigham Biobank.
His team didn’t establish a direct connection between depression and cardiovascular disease. What they did find is that having depression or anxiety can increase a person’s risk of developing other health concerns that are, in turn, likely to lead to heart problems.
Key findings from the study included:
- 38% of the participants developed diabetes, high blood pressure, or high cholesterol during the 10-year period that the study covered.
- Participants with histories of anxiety or depression prior to the study period were 55% more likely to develop these CVD risk factors than were those with no history of either mental health condition.
- The researchers found the strongest association in women under the age of 50. Among women with anxiety or depression in that age range, the rate of cardiovascular risk factors was almost 200% higher than in any other group.
- Younger women without anxiety or depression had the lowest rates of cardiovascular risk factors of all groups in the study.
Here’s how Dr. Civieri characterizes these findings:
“Once a young woman has depression or anxiety, her absolute risk is comparable to a young male. There is a sort of a catch-up phenomenon where depression and anxiety increase the risk that would otherwise be very low.”
Does Depression Cause Heart Disease?
While the team found a link between depression and cardiovascular pathologies, they didn’t establish a cause-effect relationship between the two.
However, two days the presentation, the journal JACC: Asia published a study from Japan on a similar topic. The Japanese study was much larger, involving the analysis of health records from more than 4.1 million adults over a 17-year period, from 2005-2022.
Led by Keitaro Senoo, MD, the Japanese study found “a significant association between depression and subsequent CVD events in both men and women, with a stronger association observed in women.”
As with the previous study, this research focused on establishing a connection between depression and cardiovascular disease, not identifying the causes of this connection. However, Senoo’s team offered multiple theories that could explain the stronger depression-CVD link among women, such as:
- Women with depression may have more intense, longer-lasting symptoms than men. This may increase strain on the cardiovascular system.
- Women often develop depressive disorders during times of significant hormonal changes, i.e. during pregnancy or menopause. These changes may exacerbate the impact of depression on cardiovascular health.
- Prior studies suggest that women with depression are more likely than men to have diabetes, hypertension, and/or obesity. This can increase risk of cardiovascular disease.
- Men and women interact with the healthcare system differently. For example, women are more likely than men to seek treatment, and therefore more likely to receive a diagnosis for depression.
Senoo’s team also emphasized the importance of additional research to determine exactly why depression seems to be a significant risk factor for cardiovascular disease in women:
“There is a need to better understand the potential sex-specific factors underlying the association between depression and CVD, and to develop targeted prevention and treatment strategies that address the specific cardiovascular risks faced by women with depression.”
How Can Women With Depression Reduce Risk of Heart Disease?
Various genetic and environmental factors increase risk depression or cardiovascular disease. It’s impossible to eradicate all of these factors, but women can take several important steps to minimize their risk.
Some tips are specific to either mental health or cardiovascular well-being, while others apply to both.
A September 2023 study in the journal Nature Mental Health found that certain lifestyle habits can lower a person’s risk for depression by more than 50 percent. These habits include:
- Sleeping for seven to nine hours every night
- Getting an appropriate amount of exercise
- Following the Mediterranean or MIND diet
- Consuming no more than one alcoholic drink per day
- Quitting smoking, or never starting in the first place
- Cutting back on screen time to promote physical activity
- Pursuing hobbies that promote social interaction
To promote heart health, the National Heart, Lung, and Blood Institute advises women to:
- Get at least 150 minutes of physical activity every week
- Follow a healthy diet plan that is low in sugar, sodium, and saturated fat
- Track important biomarkers such as blood pressure, body mass index (BMI), cholesterol level, and – for those with diabetes – blood sugar levels
- Get seven to nine hours of sleep every night
- Develop more effective stress-management skills
- Avoid smoking or vaping tobacco
- Maintain a healthy weight
In some cases, a person can follow all the best advice and still develop mental health or medical problems. No matter the preventive measures, it’s possible that anyone may, at some point in time, need professional care to learn how to manage their symptoms and achieve improved quality of life.
For adults with acute symptoms of depression or another mental health concern, Crownview Psychiatric Institute offers a dynamic array of evidence-based therapies and support services, all provided in a welcoming and inclusive community-like environment.
To learn more about how CPI can help you or a family member, please visit our Contact page or call us today.
Gianna Melendez
Jodie Dahl, CpHT