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    Depression and cardiovascular sequelae in postmenopausal women. The Women's Health Initiative (WHI)

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    Authors
    Wassertheil-Smoller, Sylvia
    Shumaker, Sally A.
    Ockene, Judith K.
    Talavera, Greg A.
    Greenland, Philip
    Cochrane, Barbara B.
    Robbins, John
    Aragaki, Aaron K.
    Dunbar-Jacob, Jacqueline
    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2004-02-01
    Keywords
    Aged
    Antidepressive Agents
    Cardiovascular Diseases
    Continental Population Groups
    Depression
    Dose-Response Relationship, Drug
    Estrogens
    Exercise
    Female
    Follow-Up Studies
    Humans
    Life Style
    Middle Aged
    Motor Activity
    Postmenopause
    Predictive Value of Tests
    Prevalence
    Progesterone
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Statistics as Topic
    Survival Analysis
    Treatment Outcome
    United States
    Women's Health
    Life Sciences
    Medicine and Health Sciences
    Women's Studies
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    Link to Full Text
    http://dx.doi.org/10.1001/archinte.164.3.289
    Abstract
    BACKGROUND: Subclinical depression, often clinically unrecognized, may pose increased risk of cardiovascular disease. Few studies have prospectively investigated cardiovascular events related to depression in older women. We describe prevalence, cardiovascular correlates, and relationship to subsequent cardiovascular events of depressive symptoms among generally healthy postmenopausal women. METHODS: The Women's Health Initiative Observational Study followed up 93 676 women for an average of 4.1 years. Depression was measured at baseline with a short form of the Center for Epidemiological Studies Depression Scale. Risks of cardiovascular disease (CVD) events were estimated from Cox proportional hazards models adjusting for multiple demographic, clinical, and risk factor covariates. RESULTS: Current depressive symptoms above the screening cutoff point were reported by 15.8% of women. Depression was significantly related to CVD risk and comorbidity (odds ratios ranging from 1.12 for hypertension to 1.60 for history of stroke or angina). Among women with no history of CVD, depression was an independent predictor of CVD death (relative risk, 1.50) and all-cause mortality (relative risk, 1.32) after adjustment for age, race, education, income, diabetes, hypertension, smoking, high cholesterol level requiring medication, body mass index, and physical activity. Taking antidepressant medications did not alter the depression-associated risks associated. CONCLUSIONS: A large proportion of older women report levels of depressive symptoms that are significantly related to increased risk of CVD death and all-cause mortality, even after controlling for established CVD risk factors. Whether early recognition and treatment of subclinical depression will lower CVD risk remains to be determined in clinical trials.
    Source
    Arch Intern Med. 2004 Feb 9;164(3):289-98. Link to article on publisher's site
    DOI
    10.1001/archinte.164.3.289
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/50887
    PubMed ID
    14769624
    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1001/archinte.164.3.289
    Scopus Count
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