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Depression Triples Chest Pain Rates in Medicare Patients


 

DENVER – Depression significantly increased the rates of four types of cardiovascular conditions among Medicare patients aged 65 and older, compared with Medicare patients without depression, reported Dr. Lawson R. Wulsin in a poster presented at the annual meeting of the American Psychosomatic Society.

Dr. Wulsin, professor of psychiatry and family medicine at the University of Cincinnati, and his colleagues reviewed data from 177,760 Medicare patients who were enrolled in the 1998 Medicare Health Outcomes Study. Self-reported depression for at least 2 weeks during the year prior to the study was strongly associated with chest pain at rest (relative risk 2.79), myocardial infarction (relative risk 1.49), congestive heart failure (relative risk 1.81), and stroke (relative risk 1.78).

The significant increases in risk for these four conditions persisted when the patients reported depression or sadness either “much of the past year” or “most days during any 2 years of your life” –a finding that suggests a similar effect for both recent and long-term depression in older patients.

The results support the need for depression screening among older patients with cardiovascular disease and the need to identify factors that can mitigate these effects, the investigators reported. Their analyses of covariates, including age, gender, physical and mental functioning, smoking status, and diabetes status, are pending.

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