Uncovering the Burden of Depression on Ischemic Heart Disease Mortality in the United States: A 25-Year Population Study

Authors

• Muhammad Ahmad, Private Practice of a Board-Certified Psychiatrist
• Muhammad Ibrahim, Bahria University
• Muneeza Ijaz, Private Practice of a Board-Certified Psychiatrist
• Muhammad Faseeh Hanif, Bahria University
• Akash Kumar, Private Practice of a Board-Certified Psychiatrist
• Waseem Chaudhry, New York Medical College
• Ibrahim Saqib Malik, Shifa College of Medicine
• Talha Jaffar, Bon Secours Mercy Hospital

DOI

10.1016/j.jad.2025.120752

Journal Title

Journal of Affective Disorders

Document Type

Article

Publication Date

2-15-2026

Department

Medicine

Keywords

Depression, Health disparities, Ischemic heart disease, Mortality trends, Psychiatric comorbidities

Disciplines

Medicine and Health Sciences

Abstract

Background Depression affects a substantial subset of patients with ischemic heart disease (IHD), yet national mortality trends and disparities remain inadequately characterized. This study analyses U.S. mortality patterns over 25 years where depression was documented as a contributing cause alongside IHD as the underlying cause. Methods Using CDC WONDER Multiple Cause of Death data (1999–2023), we examined age-adjusted mortality rates (AAMRs) per 100,000 for IHD as the underlying cause with documented depression as a contributing cause, providing a conservative estimate of comorbidity-related mortality. Joinpoint regression identified inflection points and average annual percent changes (AAPCs), while linear regression assessed overall linearity and interactions. Analyses were stratified by sex, race/ethnicity, age, and region. Results Overall IHD mortality significantly declined from 704.0 to 365.5 (AAPC: −2.76 %, p < 0.000001). Among IHD decedents with documented depression, mortality decreased more gradually from 3.3 to 2.4 (AAPC: −1.40 %, p = 0.008). Females demonstrated significant reductions (AAPC: −1.77 %, p < 0.001), while males did not. Non-Hispanic Whites had the highest rates with early trend reversals, whereas rates among Black individuals remained stable (AAPC: 0.24 %, p = 0.770). Regionally, mortality declined in most areas except the South, where rates stagnated. Conclusions Despite overall IHD mortality decline, patients with documented depression face a disproportionate mortality burden. The persistent underreporting of psychiatric comorbidities on death certificates likely obscures the full extent of this burden, limiting accurate surveillance and intervention. These findings emphasize the urgent need for improved recognition, standardized reporting, and integrated cardiovascular-mental health care to address disparities and improve outcomes.

Recommended Citation

Ahmad, M., Ibrahim, M., Ijaz, M., Hanif, M., Kumar, A., Chaudhry, W., Malik, I., & Jaffar, T. (2026). Uncovering the Burden of Depression on Ischemic Heart Disease Mortality in the United States: A 25-Year Population Study. Journal of Affective Disorders, 395. https://doi.org/10.1016/j.jad.2025.120752