...and may lie heavy on the heart.

Whether depression promotes certain forms of cancer or not, it can be a heartbreaker, according to a study conducted by scientists at Johns Hopkins University in Baltimore. Heart attacks show an unfortunate affinity for people who have endured major depression (with symptoms of extreme sorrow, apathy, and hopelessness) or recurring periods of intense sadness, contend epidemiologist William W. Eaton and his coworkers.

The Hopkins study is based on medical and psychiatric interviews conducted with 1,551 adult Baltimore residents in 1981 and again in 1994. None of the volunteers had a history of heart problems at the start of the project.

Over the next 13 years, the heart attack rate among people who had previously experienced major depression was more than four times that of volunteers who had no history of mood disorders; individuals who had endured the milder forms of depression before the study had twice the heart attack rate of never-depressed folks.

The researchers controlled statistically for age, sex, cigarette smoking, blood pressure, use of antidepressant drugs, and other factors that may contribute to heart problems. Potential biological consequences of major depression that foster heart attacks remain unclear, the researchers state in the December Circulation.