Association of Major Depressive Episodes With Stroke Risk in a Prospective Study of 0.5 Million Chinese Adults

They didn't seem to describe the stroke depression conundrum. After a stroke, about 33% of survivors get depressed. Which then in turn causes you to have a higher risk for another stroke. Your doctor should be able to stop that.
http://stroke.ahajournals.org/content/47/9/2203.abstract

1. Jie Sun, MD;
2. Hongxia Ma, PhD;
3. Canqing Yu, PhD;
4. Jun Lv, PhD;
5. Yu Guo, MD;
6. Zheng Bian, MD;
7. Ling Yang, PhD;
8. Yiping Chen, PhD;
9. Hongbing Shen, PhD;
10. Zhengming Chen, PhD;
11. Zhibin Hu, PhD;
12. Liming Li, PhD;
13. on behalf of the China Kadoorie Biobank Collaborative Group

+ Author Affiliations

1. From the Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, China (J.S., H.M., H.S., Z.H.); Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (C.Y., J.L., L.L.); Chinese Academy of Medical Sciences, Beijing, China (Y.G., Z.B., L.L.); and Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., Z.C.).

1. Correspondence to Zhibin Hu, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing 211166, China, E-mail zhibin_hu@njmu.edu.cn or Liming Li, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Rd, Beijing 100191, China, E-mail lmlee@vip.163.com

Abstract

Background and Purpose—Although the relationship between depression and stroke risk has been investigated, findings in previous reports were conflicting. The aim of this study was to prospectively examine the effect of major depressive episodes (MDE) on stroke incidence and further assess the potential dose–response relationship between number of depression symptoms and subsequent stroke risk in Chinese population.

Methods—A total of 199 294 men and 288 083 women aged 30 to 79 years without a history of stroke, heart disease, and cancer in the China Kadoorie Biobank cohort were followed from 2004 to 2013. A World Health Organization Composite International Diagnostic Interview-Short Form was used to access MDE according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Stroke events were ascertained through death certificates, medical records, and health insurance data.

Results—Past year MDE was marginally associated with a 15% increased risk of stroke (adjusted hazard ratio, 1.15; 95% confidence interval, 0.99–1.33) in the fully adjusted model, and the association was steeper and statistically significant in individuals aged <50 years, smokers, drinkers, those with higher education degree, body mass index <24.0 kg/m², and no history of diabetes mellitus. Moreover, there was a positive dose–response relationship between the number of depression symptoms and increased stroke risk (P_trend=0.011). In addition, smoking status significantly interacted with MDE on stroke onset (P for multiplicative interaction=0.025).

Conclusions—Findings from this large prospective study suggest that the presence of MDE is a risk factor for stroke, especially in smokers.