Men with
a similar history do not suffer as frequently from the same symptoms,
writes Leslie S. Kinder, Ph.D., of the Veterans’ Affairs Puget
Sound Health Care System, in the journal Psychosomatic Medicine.
“Perhaps the health risks linked to depression are more critical
to women,” Kinder says.
Kinder and colleagues looked at results of a national health survey conducted
between 1988 and 1994, covering more than 6,000 men and women ages 17 to
39. Women were more likely than men to have experienced a prior episode
of depression, and those women who had had at least one episode were also
more likely to suffer from the metabolic syndrome.
People with the metabolic syndrome have at least three out of five factors
linked to heart disease: high blood pressure; high triglycerides; low HDL
(good) cholesterol; high fasting blood sugar; or abdominal obesity.
“Depression in women was associated with the number of the metabolic
syndrome components present,” Kinder says, adding that the association
between depression and high blood pressure was especially strong.
The relationship held even when the researchers controlled for age, race,
education, smoking, physical inactivity, carbohydrate consumption and alcohol
use. Depression in men was not associated with the metabolic syndrome or
its components, she says.
Kinder notes that depressed people more often smoke, eat
unhealthy diets, or lead a sedentary life. They also take their medications
less often
or otherwise fail to follow their doctors’ advice. But that is unlikely
to be the whole story, she says. Depression can cause the heart to speed
up, and is also associated with poor regulation of the hormonal system
and with changes in white blood cell count, blood platelets and other
biological markers.
“Failure to recognize and treat depression in patients with the
metabolic syndrome may have deleterious physiological as well as psychological
consequences,” she says.
The survey could not determine whether the depression preceded development
of the metabolic syndrome, although other research suggests that this could
be the case.
“Regardless of whether depression is a cause, consequence or simple
marker for the metabolic syndrome, the association has important clinical
ramifications,” Kinder says. “Health care professionals should
take special care to assess the psychological status of these patients
and develop treatments that take into account the added difficulties
patients with depression pose.”
The researchers were supported by grants from the National Heart, Lung,
and Blood Institute.
