Prospective study of depressive symptoms and risk of stroke among Japanese

Background and Purpose-We sought to examine the relationship between depres sive symptoms and the incidence of stroke among Japanese men and women. Methods-A 10.3-year prospective study on the relationship between depressiv e symptoms and the incidence of stroke was conducted with 901 men and women aged 40 to 78 years in a rural Japanese community. Depressive symptoms wer e measured at baseline with the use of the Zung Self-Rating Depression Scal e (SDS), The incidence of stroke was ascertained under systematic surveilla nce, Results-During the 10-year follow-up, 69 strokes (39 ischemic strokes, 10 i ntracerebral hemorrhages, 10 subarachnoid hemorrhages, and 10 unclassified strokes) occurred. Age- and sex-adjusted prevalence of mild depression (SDS scores greater than or equal to 40) at baseline was 25% among subjects wit h incident stroke and 12% among subjects without stroke (P<0.01). Persons w ith SDS scores in the high tertile had twice the age- and sex-adjusted rela tive risk of total stroke as those with scores in the low tertile. The exce ss risk was confined to ischemic stroke. After we adjusted for body mass in dex, systolic blood pressure level, serum total cholesterol level, cigarett e smoking, current treatment with antihypertensive medication, and history of diabetes mellitus, these relative risks remained statistically significa nt for total stroke (1.9; 95% CI, 1.1 to 3.5) and ischemic stroke (2.7; 95% CI, 1.2 to 6.0). Conclusions-Depressive symptoms predict the risk of stroke, specifically is chemic stroke among Japanese.