VA Data Shows Depression and Diabetes Increase Risk of Heart Attack

Researchers examining VA patient data have shown an increased risk of myocardial infarction in patients with major depressive disorder (MDD) and type 2 diabetes.

The study used VA data on more than 500,000 patients who visited a VA facility in 1999 and 2000 and who, at the time, had no history of cardiovascular disease. Of those, 214,749 had no record of diabetes or MDD; 77,568 had MDD alone; 40,953 had type 2 diabetes alone; and 12,679 had MDD and type 2 diabetes.

During a seven-year follow-up period, researchers tracked incidents of MI in the entire 500,000-patient group. They discovered that the likelihood for MI was more likely if the patient had a history of MDD or diabetes and that there were nearly three times as many MI events among patients with a history of both diseases than in patients that had no history.

In patients with no history of MDD or diabetes, the MI rate was 2.6%; for MDD alone it was 3.5%; for diabetes alone it was 5.9%; and for patients with a history of both, the rate was 7.4%. The researchers calculated the multi-variate-adjusted hazard ratio at 1.29 for a history of MDD only, 1.33 for a history of diabetes only, and 1.82 for a history of both.

Previous studies have shown that diabetes can trigger depression. The long-term stress associated with diabetes management can lead to a decreased quality of life and a greater risk for depression. Also, studies have found that there might be biological similarities between the two conditions. The result is that patients with comorbid MDD and type 2 diabetes are not uncommon, especially in the VA system where the average patient age is older and has more chronic health problems.

The researchers concluded that the data shows a definite risk for new-onset MI in depressed patients with type 2 diabetes, and that increased monitoring of this patient group may reduce the risk of MI.

1: Scherrer JF, Garfield LD, Chrusciel T, Hauptman PJ, Carney RM, Freedland KE, Owen R, True WR, Lustman PJ. Increased risk of myocardial infarction in depressed patients with type 2 diabetes. Diabetes Care. 2011 Aug;34(8):1729-34. Epub 2011 Jun 16. PubMed PMID: 21680721; PubMed Central PMCID: PMC3142034.

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