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May 3, 2011BMC MedicineOpen Access

Should Global Burden of Disease Estimates Include Depression as a Risk Factor for Coronary Heart Disease?

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Why the study?

Is depression an independent risk factor for the development of coronary heart disease?

Population

Populations assessed for global disease burden / individuals at risk for coronary heart disease

Design

Review

Authors

FCFiona CharlsonThe University of QueenslandNSNicholas JC StapelbergGriffith UniversityABAmanda BaxterTexas A&M University

Discussion

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Implication

Current evidence supports the inclusion of major depression as an independent risk factor for coronary heart disease in global burden of disease estimates.

Key Points

  • To evaluate whether major depression fulfills established causal criteria for inclusion as an independent risk factor for coronary heart disease in the Global Burden of Disease Study.
  • Assessed epidemiological evidence and causal criteria connecting mental disorders to coronary heart disease etiology for the 2010 Global Burden of Disease Study.
  • Evaluated biological plausibility, dose-response relationships, study heterogeneity, diagnostic definitions, publication bias, and residual confounding across existing literature.
  • Current evidence confirms depression satisfies established criteria as an independent risk factor for the development of coronary heart disease, supported by biological pathways and a dose-response relationship.
  • Identified methodological challenges including measurement variations, study heterogeneity, and residual confounding, but concluded evidence is sufficient to incorporate major depression into global burden models.

Structured PICO

Is depression an independent risk factor for the development of coronary heart disease?

P
Population
Populations assessed for global disease burden / individuals at risk for coronary heart disease
I
Intervention
Depression (assessed as a risk factor)
O
Outcome
Development of coronary heart disease

Current evidence supports the inclusion of major depression as an independent risk factor for coronary heart disease in global burden of disease estimates.

Limitations

  • heterogeneity issues
  • definition and measurement of depression and coronary heart disease
  • publication bias
  • residual confounding

Cite This Study

Charlson et al. (2011) studied this question.

synapsesocial.com/papers/6a7104caf44fa9f079dec7b2https://doi.org/10.1186/1741-7015-9-47
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reflections on Depression as a Cardiac Risk Factor2005 · 259 citations
  2. 2Depression as a risk factor for ischaemic heart disease in men: population based case-control study1998 · 203 citations
  3. 3Evidence based cardiology: Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies1999 · 1,352 citations
  4. 4Assessment and treatment of depression in patients with cardiovascular disease: National heart, lung, and blood institute working group report2006 · 110 citations
  5. 5Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy1999 · 2,863 citations