Women with suspected coronary-artery disease who suffered from depression amassed up to 53 percent higher costs in cardiovascular health care in the five years after they were enrolled in an observational study and were assessed for "depressive" symptoms, says an article in the Journal of the American College of Cardiology.

The article outlines some of the latest findings from the Women's Ischemia Syndrome Evaluation (WISE), an ongoing, multicenter study funded by the National Institutes of Health. Dr. C. Noel Bairey Merz, who led the study, chairs the WISE initiative and is a nationally recognized expert in women's heart disease.

Bairey Merz is director of the Women's Heart Center at the Cedars-Sinai Heart Institute, in Los Angeles, where she also directs the Preventive and Rehabilitative Cardiac Center at the Cedars-Sinai Heart Institute. A professor of medicine at Cedars-Sinai Medical Center, she holds the Women's Guild Endowed Chair in Women's Health.

Previous studies have shown that patients suffering from both certain medical conditions and depression have greater health expenses than those who don't suffer from depression. Because women are diagnosed with depression at twice the rate of men, the study of costs related to depression and women's health issues is particularly important.

This latest study, conducted among nearly 900 women undergoing evaluations for possible coronary-artery disease, used three different approaches to measure depression—history of treatment for depression, use of antidepressant medications, and a standard, widely accepted questionnaire. Seventeen percent to 45 percent of the women in the study met depression criteria.

Depression was associated with 15 percent to 53 percent increases in cardiovascular costs over five years. Translated into dollar figures, annual cardiovascular costs were $1,550 to $3,300 higher for depressed women than for those who were not depressed, depending on the depression criteria used.

Several factors appear to be responsible for the increased costs, but one clear association is that the depressed women experienced more cardiovascular disease events. Interestingly, relationships between depression and costs were particularly strong among women who didn't have evidence of significant coronary-artery disease (CAD), suggesting that depression may play a larger cost role in women who do not have traditional markers of heart disease.

The findings suggest depression is an important factor in understanding overall and cardiovascular-related costs in women who have symptoms of heart disease, Bairey Merz says. Although it's not known whether treatment for depression can lower costs in cardiac populations, the results support future research in this area, she says.

The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health, The Women's Guild of Cedars-Sinai Medical Center, the Edythe Broad Endowment for Women's Heart Research, and other organizations.