Being single has been found to increase the risk of post-MI depession in men, whereas unmarried women or those living alone were less likely to be depressed. 98,117,119 These findings are consistent with the fact that the protective health effects of marriage are notably stronger for men than for women.119 Social networks, in relation to recurrent CVD
events were investigated in the Stockholm Female TPCA-1 order Coronary Risk Study.120 It was demonstrated that two or more depressive symptoms (BDI) and lack of social integration (number and function of social contacts) contributed independently Inhibitors,research,lifescience,medical to a relapse of CVD (cardiovascular death, MI or revascularization procedures, Inhibitors,research,lifescience,medical eg, percutaneous luminal angioplasty and coronary artery bypass grafting) within 5 years. Conclusions Due to the lack
of studies in gender-balanced populations and randomized clinical studies including a larger number of women, current knowledge of gender-related risk profiles in CVD and comorbid depression is limited. Nevertheless, there is evidence for significant gender differences in some aspects (Table I), which points to several disadvantages for women with respect to risk factors, CVD management, and outcome. Table I Evidence of gender differences in cardiovascular disease (CVD) and depression. Groups with a particularly high risk of CVD are single Inhibitors,research,lifescience,medical mothers with low socioeconomic status, working mothers with low employment grades, and older women who live alone and have little social support. At the same time, these groups are more vulnerable to depression. Depression in otherwise
healthy subjects seems to increase the risk of CVD more strongly in women, and women with CVD possibly Inhibitors,research,lifescience,medical experience higher levels of depression and lower levels of social support than men. However, single male patients also seem to be prone to a poorer outcome of CVD. While in general, depression has been shown to be an independent risk factor and consequence of CVD, the question as to whether the impact Inhibitors,research,lifescience,medical of depression on the development and progression of CVD differs as a function of gender is still unresolved. There is a need for more systematic gender studies in CVD and comorbid depression, and for the development of gender-related biopsychosocial explanatory models. Prospective studies are needed, because gender bias is of high clinical those and public health importance. There is also a need for improving the detection of depression in CVD patients, and for paying more attention to the rate of CVD in patients with major depression. It may be that depression in male CVD patients is underdiagnosed, because males tend to deny their depressive symptoms and compensate for them with attitudes and behavior such as anger, hostility, cynicism, and social withdrawal.