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Depression prevalence in cardiovascular disease: global systematic review and meta-analysis
  1. Sima Rafiei1,
  2. Samira Raoofi2,
  3. Aryan Baghaei3,
  4. Maryam Masoumi4,
  5. Maryam Doustmehraban5,
  6. Zahra Nejatifar5,
  7. Mohaddeseh Sanaei6,
  8. Farzaneh Bagheribayati7,
  9. Elahe sadat Vaziri Shahrebabak6,
  10. Maral Shayestehbonyan8,
  11. Akbar Javan Biparva9,
  12. Neda Raoofi10,
  13. Maryam Mir6,
  14. Zeinab Momeni5,
  15. Sama Yousefy5,
  16. Zahra Hashemi Khoonigh5,
  17. Fatemeh Rezaei5,
  18. Fatemeh Pashazadeh Kan6 and
  19. Ahmad Ghashghaee5,11
  1. 1 Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  2. 2 Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
  3. 3 Student Research Committee, Guilan University of Medical Sciences, Guilan, Iran
  4. 4 Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran
  5. 5 Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
  6. 6 Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
  7. 7 Cellular and Molecular Biology, University of Zanjan, Hashtgerd, Iran
  8. 8 Islamic Azad University Tehran North Branch, Tehran, Iran
  9. 9 Student Research Committee, School of Health Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
  10. 10 Cardiovascular Research Center Kermanshah, Kermanshah, Iran
  11. 11 The School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
  1. Correspondence to Ahmad Ghashghaee, The School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, G12 8QQ, UK; ahmad.ghashghaee1996{at}

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  • According to statistical reports, nearly 45% of patients with cardiovascular disease (CVD) struggle with major depressive symptoms. Based on WHO estimates, the prevalence of clinical depression in people suffering from CVD was reported up to 9% worldwide.


  • The total number of patients with CVD was reported to be 64 068 167, of which 3 687 872 suffered from depression. According to our analysis, the prevalence rate of depression in patients with cardiovascular disease was estimated at 18.4% (95% CI 15% to 22.3%).


  • Regular screening for depression in patients with CVD should be a key priority in treatment programmes at least on a yearly basis, as a major risk factor for the disease.


In accordance with the WHO, people with mental health issues including depression are regarded as a vulnerable group who should be given special attention in health promotion and preventive programmes. These vulnerable people often suffer from higher rates of discrimination and reduced access to health and social services, which ultimately might negatively affect their quality of life.1 2 It has been noted that when cardiac disease and depression occur simultaneously in the same individual, the prognosis of both diseases will intensify and accelerate.3 According to statistical reports, nearly 45% of patients with cardiovascular disease (CVD) struggle with major depressive symptoms.4 Research has also found that depression is more common in cardiac patients and plays as a crucial risk factor for cardiac morbidity and mortality.5

Another justification for the association between depression and CVD is adherence to pharmacological and medical treatments which is recommended to cardiac patients. In fact, some of the features of depression contribute to the ideas and feelings of patients towards the disease, tendency to heal, confidence and trust in healthcare professionals and, most importantly, medical adherence, which ultimately affect the progression of the …

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  • Contributors Conception and design of study: SRaf, AG, FPK and ZN; acquisition of data: SRaf, FPK, SRao, MSa, FB, NR, EsVS, MSh, ZHK and FR; analysis and/or interpretation of data: AG; drafting the manuscript: AJB, AG, MM and MD; revising the manuscript critically for important intellectual content: ZM, SY, AG, FPK, SRaf, AB and MM; approval of the version of the manuscript to be published: SRaf, AG and SRao,

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.