Abstract
Depression is well known to contribute to ischemic heart disease (IHD) development. However, IHD is difficult to diagnose in the critical care setting because symptoms are masked when combined with depressive manifestations. We assessed the associations between depression and factors involved in lifestyle-related diseases. The study population was 397 consecutive patients with mental disorders, seen in our emergency room (ER) between May 2009 and May 2010. We analyzed patients with depression (n=269) as compared to other mental disorders (n=128) (Schizophrenia [n=116], Anxiety neurosis [n=8], Dissociative disorder [n=4]) in terms of individual background factors (age, gender, systolic and diastolic blood pressures, any history of IHD, hypertension, diabetes mellitus, hyperlipidemia), white blood cell count and C-reactive protein using logistic regression. When adjusted for age, the hypertension rates were significantly higher in patients with than in those without depression (40.6% vs. 19.7%; p=0.009). In a multivariate analysis, history of hypertension was independently associated with patients with and without depression (p=0.045; odds ratio, 1.97 [95% CI, 1.01-3.89]). Furthermore, the risk of moderate cardiovascular events was significantly higher in hypertensive patients with depression than in hypertensive patients without depression (34.6% vs. 13.0%, p<0.001). In conclusion, the results suggest that depression is significantly frequently accompanied by hypertension and that patients with depression need to be managed as those at an elevated risk for cardiovascular disease.
