Depression and the Risk of Stroke Morbidity and Mortality: A Meta-analysis and Systematic Review
By A. Pan, Qi Sun, O. Okereke, K. Rexrode, F. B. Hu. Journal of the American Medical Association (JAMA), 2011
818 citations recorded by the source corpus.
Context Several studies have suggested that depression is associated with an increased risk of stroke; however, the results are inconsistent. Objective To conduct a systematic review and meta-analysis of prospective studies assessing the association between depression and risk of developing stroke in adults. Data Sources A search of MEDLINE, EMBASE, and PsychINFO databases (to May 2011) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews. Study Selection We included prospective cohort studies that reported risk estimates of stroke morbidity or mortality by baseline or updated depression status assessed by self-reported scales or clinician diagnosis. Data Extraction Two independent reviewers extracted data on depression status at baseline, risk estimates of stroke, study quality, and methods used to assess depression and stroke. Hazard ratios (HRs) were pooled using fixed-effect or random-effects models when appropriate. Associations were tested in subgroups representing different participant and study characteristics. Publication bias was evaluated with funnel plots and Begg test. Results The search yielded 28 prospective cohort studies (n = 317540 participants) that reported 8478 stroke cases (morbidity and mortality) during a follow-up period ranging from 2 to 29 years. The pooled adjusted HRs were 1.45 (95% confidence interval [CI], 1.29–1.63; P-for-heterogeneity <0.001; random-effects model) for total stroke, 1.55 (1.25–1.93; P-for-heterogeneity = 0.31; fixed-effects model) for fatal stroke (8 studies), and 1.25 (1.11–1.40; P-for-heterogeneity = 0.34; fixed-effects model) for ischemic stroke (6 studies). The estimated absolute risk differences associated with depression were 106 cases for total stroke, 53 cases for ischemic stroke, and 22 cases for fatal stroke per 100 000 individuals per year. The increased risk of total stroke associated with depression was consistent across most subgroups. Conclusion Depression is associated with a significantly increased risk of stroke morbidity and mortality.
Subfields: Cardiology and Cardiovascular Medicine, Epidemiology, Rehabilitation
View Paper: https://www.semanticscholar.org/paper/c84b67ed7e2f6765d550529386e6089339e3f91a
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In Cardiology and Cardiovascular Medicine
Citations in the corpus
- Epidemiology of depression and diabetes: a systematic review. (2012, background): “Even where studies have used longitudinal research designs (Brown et al., 2006; Engum, 2007; Fisher et al., 2008; Golden et al., 2008; Icks et al., 2008; Lin et al., 2009; Collins et al., 2009; Campayo et al., 2010; Pan et al., 2011; Paddison et al., 2011), examining the direction of the relationshi”
- Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2014, result): “The cumulative ORs for studies that included only men or only women revealed no difference in the strength of association between depression and stroke compared with the cumulative OR for studies that included both sexes.(399)”
- Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies (2019, background): “as stroke [6] and coronary heart disease [7, 8].”