What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Depression (n=744179). Intervention: Depression vs. Without depression. Primary outcome: First-ever stroke (RR 1.47, 95% CI 1.30 to 1.66, p=<0.001).

What does this research mean for the field?

Depression increases the risk of first-ever stroke by 47% compared to individuals without depression. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 27, 2024Open Access

Comparison of Risk of Stroke in Patients With and Without Depression: A Systematic Review and Meta-Analysis

Q: What are the key findings of this study?

Depression increased the risk of first-ever stroke by 47% compared to individuals without depression (RR 1.47).

Q: What does this research mean for the field?

Depression increases the risk of first-ever stroke by 47% compared to individuals without depression. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Depression increased the risk of first-ever stroke by 47% compared to individuals without depression (RR 1.47).

Study Design

Type

Meta-Analysis (n=744,179)

Structured PICO

Does depression increase the risk of stroke?

Population

15 studies pooling 744,179 individuals

Intervention

Depression (exposure)

Comparator

Individuals without depression

Outcome

Risk of strokehard clinical

Depression is associated with a 47% increased risk of stroke, highlighting the importance of targeted preventive strategies in depressed individuals.

Main Result

Effect estimate: RR 1.47 (95% CI 1.30 to 1.66)

p-value: p=<0.001

Limitations

Clinical and methodological diversity across the included studies resulting in moderate heterogeneity.
Diverse self-reporting mood scales employed, potentially introducing misclassification and information bias.
Most published studies defined outcome measures as any stroke subtype rather than focusing on specific subtypes or etiology.

Abstract

Individuals with depression face an elevated stroke risk, marked by an unfavorable prognosis. This meta-analysis aims to determine the impact of depression on stroke risk. The current meta-analysis was conducted using the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We selected studies through a systematic review of electronic databases, including PubMed, EMBASE, and CINAHL from January 2011 to January 2023. Google Scholar was utilized to identify supplementary studies. Furthermore, we scrutinized citation lists of reported articles for additional potential studies. Only English-language articles were included in the review. A total of 15 studies were included in this meta-analysis. The pooled sample size was 744,179. Sample size of the included studies ranged from 560 to 487,377. The pooled estimate of 15 studies showed that the risk of stroke was 1.47 times higher in individuals with depression compared to the individuals without depression, and the difference is statistically significant (RR: 1.47, 95% CI: 1.30 to 1.66, p-value<0.001). Age and hypertension emerged as significant predictors of stroke risk in depressed individuals identified through meta-regression. These findings underscore the importance of targeted preventive strategies for depression-related stroke risk, especially considering age-specific considerations and associated factors.

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