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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. [ABSTRACT FROM AUTHOR]

Background Depression and cardiovascular diseases are both common among elderly. Depression is suspected to be an independent risk factor for the onset of coronary heart disease, yet it is not clear to what extent and if depression also is associated with the onset of other diseases of the circulatory system. Aims To estimate the risk of depression as an independent risk factor for various cardiovascular diseases (CVD) and explore the effects of heterogeneity and methodological quality. Method Meta-analyses and meta-regression analyses of longitudinal cohort and case-control studies reporting depression at baseline and CVD outcomes at follow-up. Data sources MEDLINE (1966–2005) and PSYCHINFO (1966–2005). Results Of the 28 studies that met the inclusion criteria, 11 were assesed as high quality studies. Although depressed mood increased the risk for a wide range of CVDs, heterogeneity was substantial in most cases. Only the overall combined risk of depression for the onset of myocardial infarctions (n=8, OR=1.60, 95%CI 1.34–1.92) was homogenous. Clinically diagnosed major depressive disorder was identified as the most important risk factor for developing CVD. Conclusions Depression seems to be an independent risk factor for the onset of a wide range of CVDs, although this evidence is related to a high level of heterogeneity. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To determine whether older primary care patients with a Major Depressive Disorder (MDD) have lower heart rate variability (HRV) compared to non-depressed patients. HRV is a measure of cardiac autonomic functioning. Method A cross-sectional comparison of 136 elderly persons with MDD and 136 non-depressed controls (matched for age and gender) recruited in family practices in the Netherlands. Depression was determined according to the DSM–IV criteria using the PRIME–MD. HRV was measured with an electrocardiogram (ECG) during a 5-minute supine rest. Results Multivariate analyses showed statistically significant decrease in HRV in MDD patients compared with controls. Conclusion Older primary care patients with MDD have a reduced HRV. This may explain why depression is a risk factor for cardiovascular disease and mortality. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]