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dc.contributor.authorSmoller, Jordan W.
dc.contributor.authorAllison, Matthew
dc.contributor.authorCochrane, Barbara B.
dc.contributor.authorCurb, J. David
dc.contributor.authorPerlis, Roy H.
dc.contributor.authorRobinson, Jennifer G.
dc.contributor.authorRosal, Milagros C.
dc.contributor.authorWenger, Nanette K.
dc.contributor.authorWassertheil-Smoller, Sylvia
dc.date2022-08-11T08:10:19.000
dc.date.accessioned2022-08-23T17:04:12Z
dc.date.available2022-08-23T17:04:12Z
dc.date.issued2009-12-14
dc.date.submitted2014-07-24
dc.identifier.citationSmoller JW, Allison M, Cochrane BB, Curb JD, Perlis RH, Robinson JG, Rosal MC, Wenger NK, Wassertheil-Smoller S. Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women's Health Initiative study. Arch Intern Med. 2009 Dec 14;169(22):2128-39. doi:10.1001/archinternmed.2009.436.
dc.identifier.issn0003-9926 (Linking)
dc.identifier.doi10.1001/archinternmed.2009.436
dc.identifier.pmid20008698
dc.identifier.urihttp://hdl.handle.net/20.500.14038/44588
dc.description.abstractBACKGROUND: Antidepressants are commonly prescribed medications, but their effect on cardiovascular morbidity and mortality remains unclear. METHODS: Prospective cohort study of 136 293 community-dwelling postmenopausal women in the Women's Health Initiative (WHI). Women taking no antidepressants at study entry and who had at least 1 follow-up visit were included. Cardiovascular morbidity and all-cause mortality for women with new antidepressant use at follow-up (n = 5496) were compared with those characteristics for women taking no antidepressants at follow-up (mean follow-up, 5.9 years). RESULTS: Antidepressant use was not associated with coronary heart disease (CHD). Selective serotonin reuptake inhibitor (SSRI) use was associated with increased stroke risk (hazard ratio [HR],1.45, [95% CI, 1.08-1.97]) and all-cause mortality (HR,1.32 [95% CI, 1.10-1.59]). Annualized rates per 1000 person-years of stroke with no antidepressant use and SSRI use were 2.99 and 4.16, respectively, and death rates were 7.79 and 12.77. Tricyclic antidepressant (TCA) use was associated with increased risk of all-cause mortality (HR,1.67 [95% CI, 1.33-2.09]; annualized rate, 14.14 deaths per 1000 person-years). There were no significant differences between SSRI and TCA use in risk of any outcomes. In analyses by stroke type, SSRI use was associated with incident hemorrhagic stroke (HR, 2.12 [95% CI, 1.10-4.07]) and fatal stroke (HR, 2.10 [95% CI, 1.15-3.81]). CONCLUSIONS: In postmenopausal women, there were no significant differences between SSRI and TCA use in risk of CHD, stroke, or mortality. Antidepressants were not associated with risk of CHD. Tricyclic antidepressants and SSRIs may be associated with increased risk of mortality, and SSRIs with increased risk of hemorrhagic and fatal stroke, although absolute event risks are low. These findings must be weighed against quality of life and established risks of cardiovascular disease and mortality associated with untreated depression.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20008698&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/archinternmed.2009.436
dc.subjectAged
dc.subjectAntidepressive Agents
dc.subjectCardiovascular Diseases
dc.subjectFemale
dc.subjectHumans
dc.subjectIncidence
dc.subjectMiddle Aged
dc.subjectPostmenopause
dc.subjectProspective Studies
dc.subjectRisk Factors
dc.subjectWomen's Health
dc.subjectBehavior and Behavior Mechanisms
dc.subjectCardiovascular Diseases
dc.subjectCommunity Health
dc.subjectCommunity Health and Preventive Medicine
dc.subjectMental Disorders
dc.subjectPublic Health
dc.subjectWomen's Health
dc.titleAntidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women's Health Initiative study
dc.typeJournal Article
dc.source.journaltitleArchives of internal medicine
dc.source.volume169
dc.source.issue22
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/prc_pubs/26
dc.identifier.contextkey5825775
html.description.abstract<p>BACKGROUND: Antidepressants are commonly prescribed medications, but their effect on cardiovascular morbidity and mortality remains unclear.</p> <p>METHODS: Prospective cohort study of 136 293 community-dwelling postmenopausal women in the Women's Health Initiative (WHI). Women taking no antidepressants at study entry and who had at least 1 follow-up visit were included. Cardiovascular morbidity and all-cause mortality for women with new antidepressant use at follow-up (n = 5496) were compared with those characteristics for women taking no antidepressants at follow-up (mean follow-up, 5.9 years).</p> <p>RESULTS: Antidepressant use was not associated with coronary heart disease (CHD). Selective serotonin reuptake inhibitor (SSRI) use was associated with increased stroke risk (hazard ratio [HR],1.45, [95% CI, 1.08-1.97]) and all-cause mortality (HR,1.32 [95% CI, 1.10-1.59]). Annualized rates per 1000 person-years of stroke with no antidepressant use and SSRI use were 2.99 and 4.16, respectively, and death rates were 7.79 and 12.77. Tricyclic antidepressant (TCA) use was associated with increased risk of all-cause mortality (HR,1.67 [95% CI, 1.33-2.09]; annualized rate, 14.14 deaths per 1000 person-years). There were no significant differences between SSRI and TCA use in risk of any outcomes. In analyses by stroke type, SSRI use was associated with incident hemorrhagic stroke (HR, 2.12 [95% CI, 1.10-4.07]) and fatal stroke (HR, 2.10 [95% CI, 1.15-3.81]).</p> <p>CONCLUSIONS: In postmenopausal women, there were no significant differences between SSRI and TCA use in risk of CHD, stroke, or mortality. Antidepressants were not associated with risk of CHD. Tricyclic antidepressants and SSRIs may be associated with increased risk of mortality, and SSRIs with increased risk of hemorrhagic and fatal stroke, although absolute event risks are low. These findings must be weighed against quality of life and established risks of cardiovascular disease and mortality associated with untreated depression.</p>
dc.identifier.submissionpathprc_pubs/26
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavioral Medicine
dc.source.pages2128-39


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