The Impact of Depression on Cardiovascular Disease: A Nationwide Population-Based Cohort Study in Korean Elderly

BACKGROUND: Depression is suggested to be associated with cardiovascular disease, including ischemic heart disease and cerebrovascular disease. This study investigated the impact of depression on cardiovascular disease in the elderly population in Korea. METHODS: This retrospective cohort study was performed using the Senior Cohort database released by the Korean National Health Insurance Services from January 1, 2008 to December 31, 2012, or January 1, 2009 to December 31, 2013. The study group constituted participants newly diagnosed with depression, but not cardiovascular disease. The control group constituted participants with no past history of depression or cardiovascular disease, and were not diagnosed with depression during the follow-up period. During the 5-year follow-up period, development of ischemic heart disease or cerebrovascular disease was assessed. Depression and cardiovascular disease were identified using the International Classification of Diseases, 10th revision, Clinical Modification codes. The data was analyzed using Cox proportional hazards model. RESULTS: The hazard ratio (HR) between depression and ischemic heart disease was 1.38 (95% confidence interval [CI], 1.23 to 1.55) and the HR between depression and cerebrovascular disease was 1.46 (95% CI, 1.32 to 1.62), after adjusting all confounding variables. CONCLUSION: Independent of other cardiovascular risk factors, depression increased the risk of ischemic heart disease by 38% and cerebrovascular disease by 46% among older adults in Korea. Since depression may increase the risk of cardiovascular disease, future research should focus on the diagnosis and prevention of cardiovascular disease in people with depression.