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Feeling Depressed? You May Be at Higher Risk of Stroke


by Keith Mulvihill

NEW YORK (Reuters Health) - Those who suffer symptoms of depression are at an increased risk of stroke, according to researchers from the Centers for Disease Control and Prevention (CDC). In particular, depressed African Americans showed the largest increase in stroke risk, the investigators report in the July/August issue of Psychosomatic Medicine.

Those people with the highest levels of depression had a 73% increase in their risk of stroke, and people with an intermediate level of symptoms for depression had a 25% increase in their stroke risk. However, it is not clear if the depression actually caused the stroke, or if some unknown factor related to stroke risk prompted depression prior to the event.

``Our results show that everybody who suffers depression should be concerned about their stroke risk, not just those with high levels of depression,'' Dr. Bruce S. Jonas of the Center for Advancement of Health at the CDC in Hyattsville, Maryland, told Reuters Health in an interview.

However, ``we are not saying that depressed people will have a stroke. Our study showed a strong association, it did not demonstrate causality,'' he said.

The researchers studied 6,095 healthy adults, who were aged 25 to 74 in the early 1970s. Participants were followed for a maximum of 22 years during which they completed a series of questionnaires that asked them detailed questions about their health and psychological histories.

African Americans who were rated as having high levels of depression showed a 160% increase in risk of stroke compared with their nondepressed counterparts. White men saw an increase of 68% and white women had a 52% increase in stroke risk, compared with people who were not depressed, according to Jonas.

The study took into account many other risk factors including age, gender, smoking status, blood pressure and cholesterol level, which have been shown to have some effect on a person's risk of having a stroke.

``How or why depression could elevate one's risk for stroke remains unclear. A possible mechanism remains unclear,'' Jonas told Reuters Health.

``One possible explanation may be that depression contributes to an increase in hypertension (high blood pressure), which in turn leads to an elevated risk for stroke,'' he explained.

Every 53 seconds, someone in America has a stroke. About 600,000 Americans will have a stroke this year, and 160,000 of them will die. In fact, stroke is our nation's No. 3 killer, and one of the leading causes of disability, according to the American Heart Association.

``People need to understand that our study opens the possibility that depression may be an additional risk factor pending further investigation,'' Jonas said. ``It is not appropriate for physicians to screen for depression (at this time) because we don't know the exact relationship between stroke and depression.''

SOURCE: Psychosomatic Medicine 2000;62.

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