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A Narrative Review of the Association Between Depression and Heart Disease Among Women: Prevalence, Mechanisms of Action, and Treatment

  • Women and Ischemic Heart Disease (J.M. Peña and F. Lin, Section Editors)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Sex and gender differences exist with regard to the association between depression and cardiovascular disease (CVD). This narrative review describes the prevalence, mechanisms of action, and management of depression and CVD among women, with a particular focus on coronary heart disease (CHD).

Recent Findings

Women versus men with incident and established CHD have a greater prevalence of depression. Comorbid depression and CHD in women may be associated with greater mortality, and treatment inertia. Proposed mechanisms unique to the association among women of depression and CHD include psychosocial, cardiometabolic, behavioral, inflammatory, hormonal, and autonomic factors.

Summary

The literature supports a stronger association between CHD and the prevalence of depression in women compared to men. It remains unclear whether depression treatment influences cardiovascular outcomes, or if treatment effects differ by sex and/or gender. Further research is needed to establish underlying mechanisms as diagnostic and therapeutic targets.

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Funding

This work was supported by funds from the National Institutes of Health (R01 HL114924). The NIH had no role in the design and conduct of the study, including the collection, management, analysis, interpretation of the data, preparation, review or approval of the manuscript, and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Medicine, Columbia University Irving Medical Center/New York Presbyterian, New York, NY, USA

    Danielle Rome

  2. Columbia University, New York, NY, USA

    Alyssa Sales

  3. Center for Family and Community Medicine, Columbia University Irving Medical Center/New York Presbyterian, New York, NY, USA

    Rebecca Leeds

  4. Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA

    John Usseglio, Talea Cornelius & Nathalie Moise

  5. Departments of OB/GYN and Psychiatry, School of Physicians and Surgeons, Columbia University Vagelos, New York, NY, USA

    Catherine Monk

  6. Departments of Internal Medicine and Psychiatry, Yale School of Medicine, New Haven, CT, USA

    Kim G. Smolderen

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Contributions

Drs. DR and NM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: DR, NM; acquisition of data: DR, AS, JU; analysis and interpretation of data: DR, AS; drafting of the manuscript: DR, NM; critical revision of manuscript for important intellectual content: RL, JU, TC, CM, KGS, NM; statistical analysis: N/A; obtained funding: NM; study supervision: NM.

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Correspondence to Nathalie Moise.

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Competing Interests

Dr. Smolderen reports grants from Merck, Shockwave, Cardinal Health, and Johnson & Johnson, and personal fees from Optum, Cook Medical, and Abbott, outside the submitted work. Dr. Cornelius reports grants from NIH/NCATS (KL2 TR001874), during the conduct of the study (the content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH); and other from Transcendent Endeavors, LLC, outside the submitted work. The other authors declare that they have no competing interests.

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Rome, D., Sales, A., Leeds, R. et al. A Narrative Review of the Association Between Depression and Heart Disease Among Women: Prevalence, Mechanisms of Action, and Treatment. Curr Atheroscler Rep 24, 709–720 (2022). https://doi.org/10.1007/s11883-022-01048-0

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