What's as Bad for the Heart as Obesity? Try Depression

The study found only tobacco use and hypertension were worse on the heart than depression.

Depression can pose as much a risk for cardiovascular (CV) disease as obesity and high cholesterol—especially in men—according to a new study from Germany.

Researchers from the Helmholtz Zentrum München, the Technical University of Munich, and the German Center for Cardiovascular Disease published a study in the journal Atherosclerosis that examined the effects of depression on CV risk relative to other factors, such as exposure to tobacco smoke, high levels of low-density lipoprotein (LDL) cholesterol, obesity, and hypertension.

When a person has depression, both mood and body function are affected, and many patients who suffer from diabetes or CV disease have mental health conditions that inhibit the ability to exercise or stay with a medication regimen.

In comparing the risk posed by depression, relative to other known factors, the question becomes: “How big a role does each factor play?”

The researchers examined data from 3428 male patients aged 45 to 74 years over a 10-year period, with data drawn from a large population health study in Europe. Results showed that while smoking and hypertension pose greater risks than depression, being obese or having high cholesterol posed about the same risk. Depression was blamed for 15% of CV deaths, the study found.

“We invested a great deal of time in this work, just due to the long observation panel,” Karl-Heinz Ladwig, the study’s lead author, said in a statement. “Our data show that depression has a medium effect size within the range of major, non-congenital risk factors for cardiovascular diseases."

He said that in high-risk patients, physicians should automatically screen for depression—a recommendation that is consistent with a new guideline from the American Diabetes Association, which calls for better integration of behavioral health assessments into care.


Ladwig KH, Baumert J, Marten-Mittag B, et al. Room for depressed and exhausted mood as a risk predictor for all-cause and cardiovascular mortality beyond the contribution of the classical somatic risk factors in men. Atherosclerosis, 2016. DOI: 10.1016/j.atherosclerosis.2016.12.003.