Depression and coronary heart disease in women with diabetes
Abstract
OBJECTIVE: The protective effects of female gender on the appearance and course of coronary heart disease (CHD) in nondiabetic subjects are diminished in the presence of diabetes. Depression predicts onset of and poor outcome from CHD in nondiabetic populations. We hypothesized that the doubled rates of depression in female diabetic patients could help explain the high prevalence of CHD in women with diabetes. METHOD: Seventy-six female type 1 and type 2 diabetic patients with (N=16) or without (N=60) active major depression (DSM-III) at index evaluation underwent systematic annual investigation of diabetes and its complications for up to 10 years. Occurrences of CHD and other macrovascular complications were examined in relation to depression status using survival analysis statistics. A multivariate model incorporating other CHD risk factors (age, duration of diabetes, body mass index, glycosylated hemoglobin, and presence of hypertension, hyperlipidemia, or tobacco use) was used to determine independent effects of depression on outcome. RESULTS: Development of CHD was significantly more rapid in the depressed subset (p<0.01 between 10-year curves), an effect that persisted after controlling for base-line differences in body mass index. Depression also was retained as an independent predictor of CHD in the multivariate model with an age-adjusted hazard ratio of 5.2 (95% CI: 1.4-18.9; p=.01). In contrast, depression did not predict the development of clinically apparent peripheral or cerebrovascular disease. CONCLUSIONS: In this sample of diabetic women, major depression was an independent risk factor that accelerated the development of CHD. Depression recognition and management may improve outcomes from diabetes in this gender subgroup.
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Women have significantly higher depression rates than men regardless of diabetes type.
“Regardless of diabetes type, women have significantly higher rates of depression than men (56).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [56]
Regardless of diabetes type, women have significantly higher rates of depression than men.
“Regardless of diabetes type, women have significantly higher rates of depression than men (390).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [390]
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- Authors
- Clouse, R. E., Lustman, P. J., Freedland, K. E., Griffith, L. S., McGill, J. B., & Carney, R. M.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- Psychosomatic Medicine
- Published
- 2003-05
- Volume
- 65
- Issue
- 3
- Pages
- 376-383
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W1975811024
- Cited by
- 179
- References
- 60
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 8 · 2020: 4 · 2019: 9 · 2018: 3 · 2017: 10 · 2016: 6 · 2015: 8 · 2014: 7 · 2013: 11 · 2012: 8
- FWCI
- 7.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dk053060-05, 5p60dk020579-35)
- National Heart, Lung, and Blood Institute (U01HL058946, 1UO-1HL58946)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK59364, 5P60 DK20579, DK-36452, DK53060, K24DK059364, R01DK036452)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- depression, coronary artery disease, diabetes mellitus, women, type 1 diabetes, type 2 diabetes, macrovascular complications, cardiovascular risk factors, depression as risk factor, gender differences
- MeSH terms
- Adult, Angina Pectoris, Coronary Disease, Depressive Disorder, Diabetes Mellitus, Diabetic Angiopathies, Female, Humans, Hyperlipidemias, Middle Aged, Myocardial Infarction, Obesity, Prospective Studies, Risk Factors, Smoking, Comorbidity, Life Tables, Incidence, Peripheral Vascular Diseases, Disease Progression
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