Gender Differences in the Associations Between Depressive Symptoms, Cardiovascular Diseases, and All-cause Mortality

Purpose: We examine the relationships between depressive symptoms and all-cause mortality and cardiovascular disease (CVD) in a representative sample of the Finnish population.

Methods: Subjects included men (N Z 3,850) and women (N Z 4,083) aged 25-74 years who had participated in risk factor surveys (The FINRISK Study) conducted in Finland in 1992 and 1997. Depressive symptoms were measured with the Beck Depression Inventory (BDI).

Results: During a 10-15 year follow-up, there were 422 deaths and 305 nonfatal and fatal CVD events among men and 195 deaths and 145 CVD events among women. Subjects in the third BDI quartile and the highest BDI quartile had higher risk for all-cause mortality than subjects in the first quartile (relative risk [RR], 1.39; 95% confidence interval [CI]: 1.03-1.86; RR, 1.64; 95% CI, 1.24-2.17, respectively) after adjustment for age, gender, education, smoking, alcohol consumption, and chronic diseases. Among women without a history of CVD, females in the highest BDI quartile had a relative risk of 1.84 (95% CI, 1.06-3.20) compared with those in the first quartile for nonfatal and fatal CVD events after adjusting for age, education, smoking, body mass index, blood pressure, cholesterol, and alcohol consumption.

Conclusions: The relationship between depressive symptoms and CVD varies according to gender and previous history of CVD.