Increased risk of coronary heart disease in female smokers

摘要

Rachel Huxley and and Mark Woodward (Oct 8, p 1297) show in their meta-analysis that smoking confers a 25% greater relative risk of coronary heart disease in women than in men. Although they propose several possible explanations for this finding, Huxley and Woodward miss depression as a likely confounding factor. One of the most widely documented findings in psychiatric epidemiology is that women have a higher prevalence of major depression than do men. For example, women were about 1.7 times more likely to report a lifetime history of major depressive episodes than were men in the US National Comorbidity Survey.