Key result
Depression is linked to a ~116% increase in all-cause mortality among postmenopausal women.
Why the study?
The association of depression, untreated hypertension, and diabetes with all-cause mortality in community-based postmenopausal women was unclear.
Do depression, untreated hypertension, and untreated diabetes increase the risk of all-cause mortality in postmenopausal women?
Cohort (n=863)
Do depression, untreated hypertension, and untreated diabetes increase the risk of all-cause mortality in postmenopausal women?
Depression and untreated hypertension independently increase mortality risk in postmenopausal women, with a synergistic effect when depression co-exists with hypertension or diabetes.
Should not yet change practice; leaves open whether treating depression or hypertension improves survival in postmenopausal women.
OBJECTIVE: To explore the association of depression, as well as untreated hypertension or diabetes with all-cause death in community-based postmenopausal women in Beijing. METHODS: A cohort of 863 community-based postmenopausal women with no history of cardiovascular heart disease (CHD), stroke, cancer, or dementia was investigated on 20 July-28 September 2009 at baseline. Depression was diagnosed using the 30-item Center for Epidemiologic Studies Depression (CES-D) scale with CES-D ≥ 11. Meanwhile, data on health behavior, physical comorbidity, and social support at baseline were collected. These individuals were followed up from 20 July to 30 August 2014. All-cause mortality and cause of death were surveyed. RESULTS: After a median follow-up of 4.97 years, 120 subjects died of all-cause. Twenty-four died of stroke, 19 died of myocardial infarction, 21 died of cancer. The others died of aging, infection, and accident. Depression and untreated HP were significantly associated with all-cause mortality in Cox models after full adjustment for all of the potential confounders (Depression HR: 2.16, 95%CI: 1.35-3.46; Untreated hypertension HR: 1.84, 95%CI: 1.12-3.02). However, negative correlation of untreated diabetes on all-cause mortality was observed in this population (HR: 1.36, 95%CI: 0.75-2.49). When depression was co-existing with hypertension/diabetes, the HR for mortality elevated significantly (Depression co-existing with hypertension HR = 3.87, 95% CI: 2.07-7.23; Depression co-existing with diabetes HR = 5.02, 95% CI: 1.5-16.79). CONCLUSIONS: : HP: Hypertension; DM: Diabetes; TC: Cholesterol; TG: Triglyceride; BMI: Body-Mass Index; CES-D: Center for Epidemiologic Studies Depression; CDC: Centers for Disease Control and Prevention; HR: Hazard Ratio; CI: Confidence Interval; ADL: Activities of daily living scale.
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Guan et al. (2020) conducted a cohort in Postmenopausal women (n=863). Depression vs. No depression was evaluated on All-cause mortality (HR 2.16, 95% CI 1.35-3.46). Depression and untreated hypertension were significantly associated with increased all-cause mortality in postmenopausal women (HR 2.16; 95% CI 1.35-3.46 and HR 1.84; 95% CI 1.12-3.02, respectively).
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