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Cited by 643Cardiac Health and Mental HealthAcute Myocardial Infarction ResearchTreatment of Major Depression

Depression, Psychotropic Medication, and Risk of Myocardial Infarction: Prospective Data From the Baltimore ECA Follow-up

Pratt, Laura A., Ford, Daniel E., Crum, Rosa M., Armenian, Haroutune K., Gallo, Joseph J., Eaton, William W.·1996·Circulation
DOI 10.1161/01.cir.94.12.3123
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Abstract

Background There is suggestive evidence that depression increases risk of myocardial infarction (MI), but there are no prospective studies in which the measure of depression corresponds to clinical criteria. This study examines prospectively whether a major depressive episode increases the risk of incident MI and evaluates the role of psychotropic medication use in this relationship. Methods and Results The study is based on a follow-up of the Baltimore cohort of the Epidemiologic Catchment Area Study, a survey of psychiatric disorders in the general population. A history of major depressive episode, dysphoria (2 weeks of sadness), and psychotropic medication use were assessed in 1981, and self-reported MI was assessed in 1994. Sixty-four MIs were reported among 1551 respondents free of heart trouble in 1981. Compared with respondents with no history of dysphoria, the odds ratio for MI associated with a history of dysphoria was 2.07 (95% CI, 1.16 to 3.71), and the odds ratio associated with a history of major depressive episode was 4.54 (95% CI, 1.65 to 12.44), independent of coronary risk factors. In multivariate models, use of barbiturates, meprobamates, phenothiazines, and lithium was associated with an increased risk of MI, whereas use of tricyclic antidepressants and benzodiazepines was not. Among individuals with no history of dysphoria, only lithium use was significantly associated with MI. Conclusions These data suggest that a history of dysphoria and a major depressive episode increase the risk of MI. The association between psychotropic medication use and MI is probably a reflection of the primary relationship between depression and MI.

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Crossref · 10.1161/01.cir.94.12.3123

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  • Major depressive disorder is a consistent predictor of the subsequent first onset of coronary artery disease, stroke, diabetes, heart attacks, and certain types of cancer, though evidence about major depressive disorder as a cause of physical disorders is spotty.

    “we know from meta-analyses of longitudinal studies that MDD is a consistent predictor of the subsequent first onset of coronary artery disease,97, 98 stroke,99 diabetes,100 heart attacks ,101, 102 and certain types of cancer.103”

    From The Costs of Depression (2012) · cites this paper as [100]

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Authors
Pratt, L. A., Ford, D. E., Crum, R. M., Armenian, H. K., Gallo, J. J., & Eaton, W. W.
Affiliations
Johns Hopkins University (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1996-12-15
Volume
94
Issue
12
Pages
3123-3129
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.94.12.3123
OpenAlex
W2049183084
Cited by
643
References
37
Citations by year
2026: 4 · 2025: 3 · 2024: 9 · 2023: 4 · 2022: 8 · 2021: 10 · 2020: 8 · 2019: 8 · 2018: 8 · 2017: 8 · 2016: 27 · 2015: 24 · 2014: 19 · 2013: 21 · 2012: 23
FWCI
14.22
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Alcohol Abuse and Alcoholism (K20AA000168)
  • National Heart, Lung, and Blood Institute (5-T32-HL-07024-21, T32HL007024)
  • National Institute of Mental Health (R01MH047447, MH 47447)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
depression, myocardial infarction, psychotropic drugs, major depressive episode, dysphoria, barbiturates, meprobamate, phenothiazines, lithium, tricyclic antidepressants, benzodiazepines, coronary heart disease risk, Epidemiologic Catchment Area study
MeSH terms
Adolescent, Adult, Aged, Demography, Depressive Disorder, Emotions, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Psychotropic Drugs, Risk Factors, Sex Characteristics, Socioeconomic Factors, Baltimore, Cohort Studies, Incidence, Prevalence

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