International Psychogeriatrics

Research Article

Comorbid cardiovascular disease and major depression among ethnic and racial groups in the United States

Hector M. Gonzáleza1a2 c1 and Wassim Tarrafa1

a1 Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA

a2 Program for Research on Black Americans, Institute of Social Research, University of Michigan, Michigan, USA


Background: To describe and examine the distribution, disability, and treatment associated with comorbid cardiovascular disease and major depressive disorder (CVD/MDD) among middle-aged and older ethnic/racial groups in the United States.

Methods: Cross-sectional data from a national probability sample of household resident adults (18 years and older; N = 16,423) living in the 48 coterminous United States were analyzed. We defined comorbid CVD/MDD as the presence of CVD (e.g. diabetes, hypertension, heart disease, and stroke) among adults who met MDD criteria at or after age 50 years.

Results: Two-thirds of middle-aged and older American adults meeting criteria major depression at or after age 50 years also reported a diagnosis of comorbid CVD. Blacks were most likely to meet our comorbid CVD/MDD (74.4%) criteria. The disease burden of depression was also highest among Black respondents. Differences in treatment due to race/ethnicity and comorbidity were not statistically significant.

Conclusions: Our findings indicate that among middle-aged and older US adults meeting MDD criteria more than half would also report a comorbid CVD. Comorbid CVD/MDD rates varied between the considered ethnic/race groups. Functional impairment associated with comorbid CVD/MDD was higher than MDD alone; however, depression care rates did not differ remarkably. Among middle-aged and older adults meeting MDD criteria, comorbid CVD may be the rule rather than the exception.

(Received May 05 2012)

(Reviewed June 18 2012)

(Revised October 31 2012)

(Accepted November 06 2012)

(Online publication January 07 2013)

Key words:

  • major depressive disorder;
  • depression;
  • epidemiology;
  • cardiovascular disease;
  • heart disease;
  • stroke


c1 Correspondence should be addressed to: Hector M. González, Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, 87 East Ferry Street, 226 Knapp Building, Detroit, Michigan 48202, USA. Phone: (313) 577-2297; Fax: (313) 875-0127. Email: