DEPRESSION AS A RISK FACTOR FOR ISCHEMIC-HEART-DISEASE IN MEN - POPULATION-BASED CASE-CONTROL STUDY

Objective: To determine the relation between depression, anxiety, and use of antidepressants and the onset of ischaemic heart disease. Desig n: Population based case-control study. Setting: All 5623 patients reg istered with one general practice. Subjects: 188 male cases with ischa emic heart disease matched by age to 485 male controls without ischaem ic heart disease; 139 female cases with ischaemic heart disease matche d by age to 412 female controls. Main outcome measure: Adjusted odds r atios calculated by conditional logistic regression. Results: The risk of ischaemic heart disease was three times higher among men with a re corded diagnosis of depression than among controls of the sane age (od ds ratio 3.09; 95% confidence interval 1.33 to 7.21; P = 0.009). This association persisted when smoking status, diabetes, hypertension, and underprivileged area (UPA(8)) score were included in a multivariate m odel (adjusted 2.75; 1.13 to 6.69; P = 0.03). Men with depression with in the preceding 10 years were three times more likely to develop isch aemic heart disease than were the controls (3.13; 1.27 to 7.70; P = 0. 01). Men with ischaemic heart disease had a higher risk of subsequent ischaemic heart disease than men without ischaemic heart disease (adju sted 2.34; 1.34 to 4.10; P = 0.003). Depression was not a risk factor for ischaemic heart disease in women on multivariate analysis (adjuste d 1.34; 0.70 to 2.56; P = 0.38). Anxiety and subsequent ischaemic hear t disease were not significantly associated in men or women. Conclusio n: Depression may be an independent risk factor for ischaemic heart di sease in men, but not in women.