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Depression increases risk for Heart Disease
more than Genetics or Environment
Newswise — A history of major depression
increases the risk of heart disease over and
above any genetic risks common to depression
and heart disease, according to researchers
at Washington University School of Medicine
in St. Louis and the VA.
The findings were reported at the
annual meeting of the American Psychosomatic
Society in Chicago.
The researchers analyzed data gathered from
more than 1,200 male twins who served in the
U.S. military during the Vietnam War.
The men were surveyed on a variety of health
issues in 1992, including depression, and
were assessed again in 2005.
In the study, investigators looked at the
onset of heart disease in depressed study
participants between 1993 and 2005.
Men with depression in 1992 were twice as
likely to develop heart disease in the
ensuing years, compared to men with no
history of depression.
"Based on our findings, we can say that
after adjusting for other risk factors,
depression remains a significant predictor
of heart disease," says first author Jeffrey
F. Scherrer, Ph.D., research assistant
professor of psychiatry at Washington
University School of Medicine and the St.
Louis Veterans Affairs Medical Center.
"In this study, we have demonstrated that
exposure to depression is contributing to
heart disease only in twins who have high
genetic risk and who actually develop
clinical depression.
"In
twins with high genetic risk common to
depression and heart disease, but who never
develop depression itself, there was no
increased risk for heart disease.
"The
findings strongly suggest that depression
itself independently contributes to risk for
heart disease."
The investigators were looking for evidence
of what they call incident heart disease, an
event such as a heart attack, heart surgery,
stent placement or medical treatment for
angina.
Those who had evidence of heart disease
prior to the original survey in 1992 were
excluded from this study.
Because twins were studied, the researchers
could divide participants into risk groups:
twins with high genetic and environmental
risk for depression, those with moderate
risk and those with a low risk.
The risk groups then were compared for
incident heart disease adjusting for other
influences on heart disease such as smoking,
obesity, hypertension and diabetes.
"By separating the twins into these groups
based on their genetic and environmental
risks, we are able differentiate the genetic
risks common to depression and heart disease
and the risks for heart disease from
exposure to depression," says
co-investigator Hong Xian, Ph.D., associate
professor of mathematics in medicine at
Washington University and health science
specialist at the VA.
Twins automatically are matched by age. They
normally grow up in the same family
environment, and in the case of identical
twins, they share identical DNA.
"If one twin has depression, but his twin
brother does not, both twins will share
genetic vulnerability for depression, but it
turns out the twin who was not depressed has
less risk for heart disease," says Scherrer.
"In sum, depression itself remains a
significant contributor to incident heart
disease after controlling for genes,
environment and mental and physical risk
factors."
Scherrer and Xian plan to follow these twins
as they age. They also plan to study the
effects of successful depression treatment
on heart disease risk.
Scherrer JF, Xian H, Franz CD, Lyons MJ,
Jacobson KC. Eisen SA, Kremen WS. Depression
is a risk factor for incident heart disease
in a genetically informative twin design.
Presented at the Annual Meeting of the
American Psychosomatic Society, March 4-7,
2009: Chicago, Ill.
This research was supported by grants from
the National Institute of Health and the
Veterans Administration.
Washington University School of Medicine's
2,100 employed and volunteer faculty
physicians also are the medical staff of
Barnes-Jewish and St. Louis Children's
hospitals.
The School of Medicine is one of the leading
medical research, teaching and patient care
institutions in the nation, currently ranked
third in the nation by U.S. News & World
Report.
Through its affiliations with Barnes-Jewish
and St. Louis Children's hospitals, the
School of Medicine is linked to BJC
HealthCare.
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