Depressive symptoms and 10-year risk for cardiovascular morbidity and mortality

Abstract Objectives. Depression is associated with increased physical morbidity and overall mortality. As less is known about how much depression increases the 10-year risk for fatal and nonfatal cardiovascular (CV) events, we evaluated the cross-sectional risk with two well-characterized risk functions measuring CV mortality and total CV event risk. Methods. The prevalence of increased depressive symptoms was measured with the Beck Depression Inventory (BDI), and the SCORE and Framingham risk functions were calculated in a middle-aged population-based sample (N=923). For metabolic syndrome (MetS), the modified National Cholesterol Education Program – Adult Treatment Panel III criteria were employed. Results. Depressive symptoms were associated with increased CV mortality and morbidity risk in men: OR for SCORE 2.9; 95%CI 1.4–5.7 and OR for Framingham function 2.2 (95%CI 1.1–4.2). In women, the corresponding figures were 1.4 (95%CI 0.3–6.9) and 1.3 (95%CI 0.7–2.6). The BDI scores showed significant correlations with SCORE (r=0.18 for men, P < 0.001; and r=0.14 for women, P=0.002), and Framingham function (for men r=0.16, P < 0.001; and for women r=0.13, P=0.005). Conclusions. Our results suggest that screening and effective treatment of depression are important in the primary and secondary prevention of cardiovascular events, especially in males.

[1]  J. Ioannidis,et al.  Assessment of claims of improved prediction beyond the Framingham risk score. , 2009, JAMA.

[2]  N. Rigotti,et al.  A tragic triad: coronary artery disease, nicotine addiction, and depression , 2009, Current opinion in cardiology.

[3]  A. Mykletun,et al.  No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study , 2009, Acta psychiatrica Scandinavica.

[4]  S. Keinänen-Kiukaanniemi,et al.  Depressive symptomatology is associated with decreased interleukin-1 beta and increased interleukin-1 receptor antagonist levels in males , 2009, Psychiatry Research.

[5]  D. Grobbee,et al.  The association of depression with cardiovascular mortality is partly explained by health status. The FINE Study. , 2009, Journal of affective disorders.

[6]  S. Keinänen-Kiukaanniemi,et al.  Depressive symptoms predispose females to metabolic syndrome: a 7‐year follow‐up study , 2009, Acta psychiatrica Scandinavica.

[7]  V. Vaccarino,et al.  Depressive Symptoms and Metabolic Syndrome: Is Inflammation the Underlying Link? , 2008, Biological Psychiatry.

[8]  Joel E Dimsdale,et al.  Psychological stress and cardiovascular disease. , 2008, Journal of the American College of Cardiology.

[9]  Nicholas J Wareham,et al.  Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study. , 2008, The American journal of psychiatry.

[10]  Srichand Jasti,et al.  SAS Macros for Testing Statistical Mediation in Data With Binary Mediators or Outcomes , 2008, Nursing research.

[11]  S. Keinänen-Kiukaanniemi,et al.  Metabolic syndrome predisposes to depressive symptoms: a population-based 7-year follow-up study. , 2008, The Journal of clinical psychiatry.

[12]  L. Shaw,et al.  Depression, the Metabolic Syndrome and Cardiovascular Risk , 2008, Psychosomatic medicine.

[13]  S. Reis,et al.  Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute-sponsored WISE study. , 2007, Journal of the American College of Cardiology.

[14]  S. Haffner,et al.  The metabolic syndrome and the impact of diabetes on coronary heart disease mortality in women and men: the San Antonio Heart Study. , 2007, Annals of epidemiology.

[15]  M. Laakso,et al.  The metabolic syndrome predicts cardiovascular mortality: a 13-year follow-up study in elderly non-diabetic Finns. , 2007, European heart journal.

[16]  A. Beekman,et al.  Depression in older age is a risk factor for first ischemic cardiac events. , 2006, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[17]  R. Krauss,et al.  Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. , 2005, Cardiology in review.

[18]  P. Binkley,et al.  Depressive symptoms and inflammation among heart failure patients. , 2005, American heart journal.

[19]  George P Chrousos,et al.  Major depression is associated with significant diurnal elevations in plasma interleukin-6 levels, a shift of its circadian rhythm, and loss of physiological complexity in its secretion: clinical implications. , 2005, The Journal of clinical endocrinology and metabolism.

[20]  F. Bonnet,et al.  Depressive symptoms are associated with unhealthy lifestyles in hypertensive patients with the metabolic syndrome , 2005, Journal of hypertension.

[21]  Maria Inês Schmidt,et al.  The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. , 2005, Diabetes care.

[22]  K. Matthews,et al.  Depressive Symptoms and Mortality in Men: Results From the Multiple Risk Factor Intervention Trial , 2005, Stroke.

[23]  V. Meyer-Rochow,et al.  Insulin resistance and depression: cross sectional study , 2004, BMJ : British Medical Journal.

[24]  J. House,et al.  Depressive Symptoms and Mortality Risk in a National Sample: Confounding Effects of Health Status , 2004, Psychosomatic medicine.

[25]  C. Herrmann-Lingen,et al.  Depression as a Risk Factor for Mortality in Patients With Coronary Heart Disease: A Meta-analysis , 2004, Psychosomatic medicine.

[26]  J. Tuomilehto,et al.  Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. , 2004, Archives of internal medicine.

[27]  H. White,et al.  Depression and cardiovascular morbidity and mortality: cause or consequence? , 2003, European heart journal.

[28]  H. Tunstall-Pedoe,et al.  Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. , 2003, European heart journal.

[29]  L. Wulsin,et al.  Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. , 2003, Psychosomatic medicine.

[30]  P. Cuijpers,et al.  Excess mortality in depression: a meta-analysis of community studies. , 2002, Journal of affective disorders.

[31]  M. Vanhala,et al.  The quantitative insulin sensitivity check index QUICKI predicts the onset of type 2 diabetes better than fasting plasma insulin in obese subjects: a 5-year follow-up study. , 2002, The Journal of clinical endocrinology and metabolism.

[32]  R. Ramasubbu Insulin resistance: a metabolic link between depressive disorder and atherosclerotic vascular diseases. , 2002, Medical hypotheses.

[33]  M. Deuschle Depression and cardiovascular morbidity , 2002, European Psychiatry.

[34]  D. Levy,et al.  Prediction of coronary heart disease using risk factor categories. , 1998, Circulation.

[35]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[36]  Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. , 2002, Circulation.

[37]  J. Baron,et al.  World Wide Web at: , 2001 .

[38]  C. Dowrick,et al.  The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis. , 2000, Journal of affective disorders.

[39]  R A Steer,et al.  Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. , 1999, Journal of clinical psychology.