According to the World Health Organisation WHO, 350 million people worldwide are affected by depression.* But the mental state is not all that is affected, however, and depression can also compromise the body. “Meanwhile there is little doubt that depression is a risk factor for cardiovascular diseases,” explains Karl-Heinz Ladwig. He is group leader at the Institute of Epidemiology II at the Helmholtz Zentrum München, professor of psychosomatic medicine at TUM’s Klinikum rechts der Isar as well as scientist of DZHK. „The question now is: What is the relationship between depression and other risk factors like tobacco smoke, high cholesterol levels, obesity or hypertension – how big a role does each factor play?“
In order to examine this question, Ladwig and his team analyzed data from 3,428 male patients between the ages of 45 and 74 years and observed their development over a period of ten years. “The work is based on a prospective population-based data set from the MONICA/KORA* study that, with a total term of up to 25 years, is one of the few large studies in Europe that allows such an analysis,” reports the statistician Dr. Jens Baumert of Helmholtz Zentrum München, who was also involved in the publication.
“Investigate depression in high-risk patients”
In their analyses, the scientists compared the impact of depression with the four major risk factors. “Our investigation shows that the risk of a fatal cardiovascular disease due to depression is almost as great as that due to elevated cholesterol levels or obesity,” Ladwig summarizes. The results show that only high blood pressure and smoking are associated with a greater risk. Viewed across the population, depression accounts for roughly 15 percent of the cardiovascular deaths. “That is comparable to the other risk factors, such as hypercholesterolemia, obesity and smoking,” Ladwig states. These factors cause 8.4 to 21.4 percent of the cardiovascular deaths.
“We invested a great deal of time in this work, just due to the long observation period,” says study leader Ladwig. But the effort paid off: “Our data show that depression has a medium effect size within the range of major, non-congenital risk factors for cardiovascular diseases.” Ladwig accordingly proposes consequences here: “In high risk patients, the diagnostic investigation of co-morbid depression should be standard. This could be registered with simple means.”
** KORA study: The „Kooperative Gesundheitsforschung in der Region Augsburg“ (Cooperative Health Research in the Augsburg Region) (KORA) has been examining the health of thousands of people living in the Greater Augsburg area for 30 years. The objective is to understand the effects of environmental factors, lifestyle and genes. Key topics of the KORA studies are issues involving the genesis and progress of chronic diseases, particularly cardiac infarction and diabetes mellitus. Risk factors from the area of health-related behaviour (such as smoking, nutrition, and physical activity), environmental factors (including air and noise pollution) and genetics are explored for this purpose. From the point of view of health care research, issues of utilization and costs of healthcare are examined.
The correlation between depression and cardiovascular diseases is not a one-way street, however, as Prof. Ladwig has shown in previous work. Suffering from a serious cardiovascular disease can lead to depression, which in turn can impair the patient’s recovery.
Ladwig, KH. et al. (2016): 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, doi: 10.1016/j.atherosclerosis.2016.12.003
The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich and has about 2,300 staff members. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members.
The Institute of Epidemiology II (EPI II) focuses on the assessment of environmental and lifestyle risk factors which jointly affect major chronic diseases such as diabetes, heart disease and mental health. Research builds on the unique resources of the KORA cohort, the KORA myocardial infarction registry, and the KORA aerosol measurement station. Aging-related phenotypes have been added to the KORA research portfolio within the frame of the Research Consortium KORA-Age. The institute’s contributions are specifically relevant for the population as modifiable personal risk factors are being researched that could be influenced by the individual or by improving legislation for the protection of public health.
Technical University of Munich (TUM) is one of Europe’s leading research universities, with more than 500 professors, around 10,000 academic and non-academic staff, and 40,000 students. Its focus areas are the engineering sciences, natural sciences, life sciences and medicine, com-bined with economic and social sciences. TUM acts as an entrepreneurial university that promotes talents and creates value for society. In that it profits from having strong partners in science and industry. It is represented worldwide with a campus in Singapore as well as offices in Beijing, Brussels, Cairo, Mumbai, San Francisco, and São Paulo. Nobel Prize winners and inventors such as Rudolf Diesel, Carl von Linde, and Rudolf Mößbauer have done research at TUM. In 2006 and 2012 it won recognition as a German „Excellence University.“ In international rankings, TUM regularly places among the best universities in Germany.
Contact for the media:
Communication Department, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg – Tel. +49 89 3187 2238 – Fax: +49 89 3187 3324 – E-mail:
Prof. Dr. Karl-Heinz Ladwig, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany – Tel. +49 89 3187 3623 – E-mail: