Depression is the third-leading cause of disease worldwide. It has been linked to increased risk of heart attack, angina, stroke, and death.

A study published in the journal JACC: Asia underscored the need to tailor prevention and management strategies to sex-specific factors. Women who are depressed are at a greater risk of heart problems than their male peers with depression.

Researchers evaluated data from nearly 4.2 million people who were listed in a Japanese health claims database between 2005 and 2022. Of those, nearly 2.4 million were men. They looked at participants’ weight, blood pressure, and fasting lab results at their initial exam. Those with depression had previously received that diagnosis.

Researchers found that women with depression were more likely than men to have one of the heart problems investigated — heart attack, stroke, angina, heart failure and atrial fibrillation. They suspect women may experience more severe and persistent depression symptoms than men. Those symptoms may accompany critical periods of hormonal changes, such as pregnancy or menopause.

When women are depressed, they are more likely to develop traditional risk factors for heart disease, such as high blood pressure, diabetes, and obesity.

Genetics and hormonal differences may also contribute to women’s heart disease risk.