Evidence map›Paper›PMID 21934057›Full record

SynthesisJAMA2011

Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review.

An Pan, Qi Sun, Olivia I Okereke, Kathryn M Rexrode, Frank B Hu

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 376 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
376citing papers in PubMed, 13 pooled it
31.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

376 citing papers in PubMed, 13 syntheses or guidelines pooled it, 802 citations in OpenAlex.

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  18. Association between Depression and Risk of Colorectal Cancer and Polyps: A Prospective Cohort Study from the Nurses' Health Study II.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
    Article
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316 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

An PanDepartment of Nutrition, Harvard School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA.
Qi Sun
Olivia I Okereke
Kathryn M Rexrode
Frank B Hu
Harvard University · USHarvard University Press · US

Funding

RISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8M
Risk Factors for Ischemic Stroke in WomenR01HL088521 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI REXRODE, KATHRYN M · 2008 to 2025
$9.9M
VITAL-DEP: Depression Endpoint Prevention in the VITamin D and OmegA-3 TriaLR01MH091448 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI OKEREKE, OLIVIA IFEOMA · 2010 to 2019
$6.5M
Dietary Fat Composition, Plasma Lipids, and Cognitive DeclineK08AG029813 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI OKEREKE, OLIVIA IFEOMA · 2008 to 2011
$531k
Novel Adipokines and Coronary Heart Disease in U.S. Men and Women with DiabetesK99HL098459 · NHLBI · HARVARD SCHOOL OF PUBLIC HEALTH · PI SUN, QI · 2010 to 2011
$189k
NHLBI NIH HHS HL034594NHLBI NIH HHS HL088521NHLBI NIH HHS K99 HL098459NHLBI NIH HHS K99HL098459NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL088521NIA NIH HHS K08 AG029813NIA NIH HHS K08AG029813NIMH NIH HHS R01 MH091448NIMH NIH HHS R01MH091448
6 · The paper itself

Abstract

contextSeveral studies have suggested that depression is associated with an increased risk of stroke; however, the results are inconsistent.

objectiveTo conduct a systematic review and meta-analysis of prospective studies assessing the association between depression and risk of developing stroke in adults. DATA SOURCES: A search of MEDLINE, EMBASE, and PsycINFO databases (to May 2011) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews. STUDY SELECTION: We included prospective cohort studies that reported risk estimates of stroke morbidity or mortality by baseline or updated depression status assessed by self-reported scales or clinician diagnosis. DATA EXTRACTION: Two independent reviewers extracted data on depression status at baseline, risk estimates of stroke, study quality, and methods used to assess depression and stroke. Hazard ratios (HRs) were pooled using fixed-effect or random-effects models when appropriate. Associations were tested in subgroups representing different participant and study characteristics. Publication bias was evaluated with funnel plots and Begg test.

resultsThe search yielded 28 prospective cohort studies (comprising 317,540 participants) that reported 8478 stroke cases (morbidity and mortality) during a follow-up period ranging from 2 to 29 years. The pooled adjusted HRs were 1.45 (95% CI, 1.29-1.63; P for heterogeneity <.001; random-effects model) for total stroke, 1.55 (95% CI, 1.25-1.93; P for heterogeneity = .31; fixed-effects model) for fatal stroke (8 studies), and 1.25 (95% CI, 1.11-1.40; P for heterogeneity = .34; fixed-effects model) for ischemic stroke (6 studies). The estimated absolute risk differences associated with depression were 106 cases for total stroke, 53 cases for ischemic stroke, and 22 cases for fatal stroke per 100,000 individuals per year. The increased risk of total stroke associated with depression was consistent across most subgroups.

conclusionDepression is associated with a significantly increased risk of stroke morbidity and mortality.

Indexed as

AdultDepressionHumansMorbidityMortalityProspective StudiesRisk FactorsStroke

Identifiers

PMID21934057
PMCPMC3242806
OpenAlexW2092112120

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.