In Young Women, Depression Can Mean Literal Heartbreak

Men with a similar history do not suffer as frequently from the same symptoms, writes Leslie S. Kinder, Ph.D., of the Veterans' Affairs Puget Sound Health Care System, in the journal Psychosomatic Medicine.

"Perhaps the health risks linked to depression are more critical to women," Kinder says.

Kinder and colleagues looked at results of a national health survey conducted between 1988 and 1994, covering more than 6,000 men and women ages 17 to 39. Women were more likely than men to have experienced a prior episode of depression, and those women who had had at least one episode were also more likely to suffer from the metabolic syndrome.

People with the metabolic syndrome have at least three out of five factors linked to heart disease: high blood pressure; high triglycerides; low HDL (good) cholesterol; high fasting blood sugar; or abdominal obesity.

"Depression in women was associated with the number of the metabolic syndrome components present," Kinder says, adding that the association between depression and high blood pressure was especially strong.

The relationship held even when the researchers controlled for age, race, education, smoking, physical inactivity, carbohydrate consumption and alcohol use. Depression in men was not associated with the metabolic syndrome or its components, she says.

Kinder notes that depressed people more often smoke, eat unhealthy diets, or lead a sedentary life. They also take their medications less often or otherwise fail to follow their doctors' advice. But that is unlikely to be the whole story, she says. Depression can cause the heart to speed up, and is also associated with poor regulation of the hormonal system and with changes in white blood cell count, blood platelets and other biological markers.

"Failure to recognize and treat depression in patients with the metabolic syndrome may have deleterious physiological as well as psychological consequences," she says.

The survey could not determine whether the depression preceded development of the metabolic syndrome, although other research suggests that this could be the case.

"Regardless of whether depression is a cause, consequence or simple marker for the metabolic syndrome, the association has important clinical ramifications," Kinder says. "Health care professionals should take special care to assess the psychological status of these patients and develop treatments that take into account the added difficulties patients with depression pose."

The researchers were supported by grants from the National Heart, Lung, and Blood Institute.