History of treatment for depression: Risk factor for myocardial infarctionin hypertensive patients

Objective: Psychological factors have been suspected of contributing to the development of cardiovascular disease. This study examined the relationshi p between a self-reported history of treatment for depression and subsequen t myocardial infarction among treated hypertensive patients. Methods: Parti cipants (5564) in a union-sponsored, hypertension control program in New Yo rk City, who entered the program during 1981-1994 without a history of card iovascular disease and who were asked whether they had been treated for dep ression, were followed in a prospective cohort study. The primary outcome o f interest was hospitalization or death due to myocardial infarction. Resul ts: At entry, 3.5 % of men and 6.4% of women reported a history of treatmen t for depression. During 4.9 years (average] of follow-up, 112 fatal and no nfatal myocardial infarctions were recorded. The sex-adjusted relative risk of myocardial infarction was 2.24 (confidence interval = 1.13-4.45). Contr olling for known cardiovascular risk factors with multivariate proportional hazards models, history of treatment for depression was significantly asso ciated with subsequent myocardial infarction (hazard ratio = 2.10, confiden ce interval = 1.04-4.23). Conclusions: A self-reported history of treatment for depression is independently associated with subsequent myocardial infa rction in treated hypertensive patients without prior cardiovascular diseas e. Whether additional or different treatment for depression will be cardiop rotective is unknown and merits further study.