Comorbid depression predicts poor health outcomes in patients with angina pectoris (AP). However, epidemiological data on
the depression-AP comorbidity is limited and largely restricted to studies from Western countries, making generalizability
to other regions uncertain. We aimed to provide additional epidemiological data for non-Western as well as Western countries.
The present study used population-based data gathered in 47 countries from four continents (Africa, Asia, South America, and
Europe) included in the cross-sectional 2002 WHO World Health Survey. Self-reported indicators of depression included: (a)
its diagnosis, (b) its treatment, and (c) seven symptom items to determine presence of a major depressive episode. Similarly,
information on AP comprised (a) a selfreported diagnosis, (b) self-reported AP treatment, (c) and a definition according to
the WHO Rose questionnaire. In primary analyses, we operationalized depression or AP as positive if any of the respective
indicators was present. Associations were estimated by multivariate logistic regression. In the entire sample (n = 213,264),
the odds of AP were more than doubled among those with depression [odds ratio (OR) = 2.60, 95 % confidence interval = 2.36,
2.87] versus those without depression. These positive associations were replicated across all continents and were observed
in both men and women. Likewise, meaningful associations (ORs C 1.5) were observed in virtually all individual countries (46/47).
Application of different operationalizations of depression and AP confirmed the above findings, both in the entire sample
and in continent-specific analyses. Our study extends the current evidence accrued in Western populations to non-Western populations.
The co-occurrence of AP and depression appears to represent a universal phenomenon.