Depression and Risk of Stroke Morbidity and Mortality

STROKE IS A LEADING CAUSE OF death and permanent disability, with significant economic losses due to functional impairments. Depression is highly prevalent in the general population, and it is estimated that 5.8% of men and 9.5% of women will experience a depressive episode in a 12-month period. The lifetime incidence of depression has been estimated at more than 16% in the general population. Depression has been associated with increased risks of diabetes, hypertension, and cardiovascular disease. However, whether depression increases the future risk of stroke remains unclear. A number of studies have assessed the associationbetweendepressionandsubsequent risks of stroke morbidity and mortality, suggesting that depression could be a modifiable risk factor for stroke. A previous meta-analysis that focused on cardiovascular outcomes pooled results from 10 studies published before 2005 as a secondary analysis and reported a positive association between depression and risk of stroke. Since then many more studies have been published, which allow more detailed analysis of the association between depression and stroke morbidity and Author Affiliations: Departments of Nutrition (Drs Pan, Sun, and Hu) and Epidemiology (Drs Okereke and Hu), Harvard School of Public Health, Boston, Massachusetts; Department of Psychiatry (Dr Okereke), Channing Laboratory (Drs Sun, Okereke, and Hu) and Division of Preventive Medicine (Dr Rexrode), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts. Corresponding Author: Frank B. Hu, MD, PhD, Harvard School of Public Health, 655 Huntington Ave, Boston, MA 02115 (frank.hu@channing.harvard.edu). Context Several studies have suggested that depression is associated with an increased risk of stroke; however, the results are inconsistent.