A 29% rise in female stroke rises credited to Depression

In an article published in the journal Stroke, researchers reported that stroke risk is 29% higher in adult females with clinical depression than in those in the same age group without depression. Women consuming selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Celexa, and Zoloft, are at a 39% higher risk of stroke, said authors from Harvard Medical School.

From 2000 to 2006, the investigators followed-up on the Nurses’ Health Study participants comprising 80,574 females between the ages of 54-79 with no stroke history.

Senior author, Dr. Kathryn Rexrode, explained that the severity of depression is marked by the usage of anti-depressant medications.

Rexrode wrote, “I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

On various occasions, the investigators evaluated depressive symptoms using a Mental Health Index. While 2-yearly patient anti-depressant usage reporting started in 1996, physician-diagnosed depression reporting began in 2000.

In this study, depression was defined as either being presently diagnosed with the disorder or having a history of depression.

During the 6-year follow-up period, there were 1,033 cases of stroke; of them, 22% of the participants had depression.
Compared to women with no history or diagnosis of depression, women with depression had a higher likelihood of being single, young, and regular smokers with less physical activity, and higher BMI (body mass index).

Comorbidities such as diabetes, heart disease, and high blood pressure (hypertension) were demonstrated by higher-than average number of women.

Rexrode wrote, “Depression can prevent individuals from controlling other medical problems, such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise. All these factors could contribute to increased risk.”

According to senior study author An Pan PhD, stroke risk might be raised due to various causes, including a fundamental vascular disease in the brain, or inflammation.

An Pan stated: “Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise. We cannot infer cause or fully exclude the possibility that the results could be explained by other unmeasured unknown factors. Although the underlying mechanisms remain unclear, recognizing that depressed women may be at a higher risk of stroke merits additional research into preventive strategies in this group.”

To conclude, the researchers said, “Our results suggest that depression is associated with a moderately increased risk of subsequent stroke.”