Women struggling with depression are at higher risk of stroke, according to a study by researchers at the Harvard School of Public Health and published in Stroke: Journal of the American Heart Association.

For the study, researchers looked at 80,574 women from the 2000 to 2006 Nurses’ Health Study. At the time, study participants, ages 54 to 79, had no history of stroke, and 22 percent had been diagnosed with depression, which is a common mental health disorder. Most were white registered nurses.

During the six-year study, researchers found that participants with a history of depression were 29 percent more likely to have a stroke. What’s more, this increased to 39 percent among those who took antidepressants.

On average, depressed women in the study were more likely to be single, sedentary and smokers. These nurses were also more likely to suffer from heart problems, high blood pressure and diabetes than their non-depressed counterparts. In addition, the women had higher body mass index (height to weight ratio)—indicating they were more likely to be overweight.

“Depression can prevent individuals from controlling other medical problems such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise,” said Kathryn Rexrode, MD, a Harvard School of Public Health assistant professor of medicine and the senior study author. “All these factors could contribute to increased risk.”

Rexrode added that antidepressant use in the study appeared to be an indicator of more severe depression—thus linked with higher stroke risk—rather than the cause of stroke. “This study does not suggest that people should stop their medications to reduce the risk of stroke,” Rexrode cautioned.

The importance of these findings were summed up by An Pan, PhD, a Harvard School of Public Health research scientist, and the study’s lead author.

“Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise,” Pan said.

Click here to read more about women’s stroke risk and antidepressants.