Baseline depressive symptoms modestly associated with CVD in
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It is uncertain whether depressive symptoms are independently associated with subsequent risk of cardiovascular diseases (CVDs).

This study aimed to characterize the association between depressive symptoms and CVD incidence across the spectrum of lower mood. A pooled analysis of individual-participant data from the Emerging Risk Factors Collaboration (ERFC; 162036 participants; 21 cohorts; baseline surveys, 1960-2008; latest follow-up, March 2020) and the UK Biobank (401219 participants; baseline surveys, 2006-2010; latest follow-up, March 2020) was made. Eligible participants had information about self-reported depressive symptoms and no CVD history at baseline.

Results:
-- Among 162036 participants from the ERFC (73%, women; mean age at baseline, 63 years), 5078 CHD and 3932 stroke events were recorded (median follow-up, 9.5 years).

-- Associations with CHD, stroke, and CVD were log linear. The HR per 1-SD higher depression score for CHD was 1.07; stroke, 1.05; and CVD, 1.06.

-- The corresponding incidence rates per 10?000 person-years of follow-up in the highest vs the lowest quintile of CES-D score were 36.3 vs 29.0 for CHD events, 28.0 vs 24.7 for stroke events, and 62.8 vs 53.5 for CVD events.

-- Among 401219 participants from the UK Biobank (55% were women, mean age at baseline, 56 years [SD, 8 years]), 4607 CHD and 3253 stroke events were recorded (median follow-up, 8.1 years).

-- The HR per 1-SD higher depression score for CHD was 1.11; stroke, 1.10; and CVD, 1.10.

-- The corresponding incidence rates per 10000 person-years of follow-up among individuals with PHQ-2 scores of 4 or higher vs 0 were 20.9 vs 14.2 for CHD events, 15.3 vs 10.2 for stroke events, and 36.2 vs 24.5 for CVD events.

-- The magnitude and statistical significance of the HRs were not materially changed after adjustment for additional risk factors.

Conclusively, in a pooled analysis of 563255 participants in 22 cohorts, baseline depressive symptoms were associated with CVD incidence, including at symptom levels lower than the threshold indicative of a depressive disorder. However, the magnitude of associations was modest.

Source: https://jamanetwork.com/journals/jama/article-abstract/2774050
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