Depression increases the onset of cardiovascular disease over and above other determinants in older primary care patients, a cohort study

Harm W. J. van Marwijk, Koen G. van der Kooy, Coen D. A. Stehouwer, Aartjan T. F. Beekman, Hein P. J. van Hout*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: To determine if major depressive disorder (MDD) in older primary care patients is an independent risk factor for cardiovascular events. Methods: A cohort of 143 primary care patients with depression and 139 non-depressed controls without depression (both aged over 55 years, matched for age and gender) from the Netherlands was evaluated for 2 years. MDD was diagnosed according to DSM-IV-criteria. During the follow-up period, information was collected on physical health, depression status and behavioural risk factors. CVD end points were assessed with validated annual questionnaires and were crosschecked with medical records. Results: Thirty-four participants experienced a cardiovascular event, of which 71% were depressed: 27/134 with MDD (20.1%) and 9/137 controls (6.6%). MDD was associated with a hazard ratio of 2.83 (p value 0,004, 95% CI 1.32 to 6.05) for cardiovascular events. After adjustment for cardiovascular medication, the hazard ratio was 2.46 (95% CI 1.14 to 5.30). Conclusions: In a 2-year follow-up period, baseline MDD increased the risk for CVD in older primary care patients compared with controls, over and above well-known cardiovascular risk factors.
Original languageEnglish
Article number40
JournalBMC Cardiovascular disorders
Publication statusPublished - 12 May 2015


  • Major depression
  • Primary care
  • Elderly
  • Cardiovascular health

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