Depressed women at increased risk for stroke

Women who were depressed showed a 29% increased risk for having a stroke, according to a study in the September issue of Stroke: Journal of the American Heart Assn.

If these women were taking an antidepressant, particularly selective serotonin reuptake inhibitors, the data showed they had a 39% greater chance of having a stroke. But researchers don't believe the medications alone necessarily account for the higher risk.

Women taking antidepressants may be more deeply depressed, said An Pan, PhD, the study's lead author. And depression can result in patients having problems controlling other health issues linked to strokes such as diabetes and hypertension. These patients also tend to exercise less, another contributor to increased stroke risk.

"[But] we don't want patients to withdraw their medication," said Pan, a research fellow at Harvard School of Public Health in Boston.

Instead, he said, physicians should be aware of whether a patient has depression and other conditions that could increase stroke risk. If patients have these conditions, physicians should treat depression and stroke risk factors such as hypertension, high cholesterol and diabetes. Doctors also should talk to patients about smoking and exercise, Pan said.

Between 2000 and 2006, the study's authors followed more than 80,000 women, ages 54 to 79, who had no history of stroke based on what they reported to the Nurses' Health Study, a questionnaire established for female registered nurses in 1976 and sent out a biennially. In the initial assessment, 22% of women reported being depressed or having a history of depression (link).

Within six years, 1,033 strokes were documented. The data showed that depressed women were more likely to have strokes, and the risk factor was higher for women taking antidepressants.

The study concluded that "further research is necessary to determine whether the risk associated with depression can be reduced by other therapies or preventive strategies."