Women who suffer from depression have a 29% higher risk of having a stroke, researchers from Brigham and Women’s Hospital in Boston, Mass. and Harvard Medical School wrote in the journal Stroke. Those on SSRIs (selective serotonin reuptake inhibitors), such as Celexa, Zoloft or Prozac, have a 39% higher risk, the authors informed.

The researchers carried out a six-year follow-up in the Nurses’ Health Study involving 80,574 women aged 54 to 79 years from 2000 to 2006. None of them had a history of stroke.

Senior author, Dr. Kathryn Rexrode said that anti-depressant drug use could be an indication of depression severity.

Dr. Rexrode stated:

“I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

In their study, the researchers assessed symptoms of depression several times with a Mental Health Index. Patients’ use of anti-depressants was reported every 24 months, starting in 1996, and doctors diagnosed depression starting in 2000. They defined depression as either having a history of depression or a current diagnosis.

22% of the women had depression at baseline. During the six-year follow-up period there were 1,033 cases of stroke.

The investigators found that women with depression were more likely to be smokers, with a higher body mass index, younger, less physically active, and single when compared to those with no history of depression. Women with depression also tended to have more coexisting conditions, such as diabetes, hypertension or heart disease.

Dr. Rexrode said:

“Depression can prevent individuals from controlling other medical problems, such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise. All these factors could contribute to increased risk.”

Depression may be linked to a higher risk of stroke due to inflammation, an underlying vascular disease in the brain, or some other mechanisms, senior author An Pan PhD. explained.

Pan said:

“Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise.”

Pan added:

“We cannot infer cause or fully exclude the possibility that the results could be explained by other unmeasured unknown factors. Although the underlying mechanisms remain unclear, recognizing that depressed women may be at a higher risk of stroke merits additional research into preventive strategies in this group.”

In an Abstract in the journal, the authors concluded:

” Our results suggest that depression is associated with a moderately increased risk of subsequent stroke.”

Written by Christian Nordqvist