Women 55 and younger who are depressed are twice as likely to have a heart attack, die or require artery-opening procedures, according to new research.

“Women in this age group are also more likely to have depression, so this may be one of the ‘hidden’ risk factors that can help explain why women die at a disproportionately higher rate than men after a heart attack,” said Amit Shah, M.D., M.S.C.R., study author and assistant professor of epidemiology at Emory University in Atlanta, Georgia.

Researchers evaluated depression symptoms in 3,237 people with heart disease who were scheduled for coronary angiography, an X-ray that diagnoses disease in the arteries supplying blood to the heart.

After nearly three years of follow-up, they found:

  • Each one point increase in depression symptoms was associated with a 7 percent increase in heart disease in women 55 and younger, after adjusting for other heart disease risk factors;
  • Women 55 and younger were more than twice as likely to require an artery-opening procedure, have a heart attack or die of heart disease if  they had moderate or severe depression;
  • Women 55 and younger were nearly two and a half times more likely to die from any cause during follow-up if they had moderate or severe depression;
  • Depression didn’t predict heart disease in men and older women.

“All people, and especially younger women, need to take depression very seriously,” Shah said. “Depression itself is a reason to take action, but knowing that it is associated with an increased risk of heart disease and death should motivate people to seek help.”

“Providers need to ask more questions. They need to be aware that young women are especially vulnerable to depression, and that depression may increase the risk to their heart,” Shah said.

“Although the risks and benefits of routine screening for depression are still unclear, our study suggests that young women may benefit for special consideration” remarked Viola Vaccarino, M.D., Ph.D., senior author of the study and Wilton Looney Chair of Epidemiology at Emory University. “Unfortunately, this group has largely been understudied before.”

The American Heart Association recommended in a 2008 statement that depression be formally considered a risk factor for increased heart disease risk.

The study was published in the Journal of the American Heart Association.