Depressive symptoms and major depressive disorder are independent risk factors for the development of CVD in individuals free of CVD at baseline. We find no published studies on the combined effects of depressive symptoms and CVD risk factors on CVD morbidity.
To compare the effects of depressive symptoms combined with CVD risk factors of physical inactivity, total cholesterol, systolic blood pressure, and BMI on development of incident CVD (myocardial infarction, stroke, and angioplasty).
Study participants (n=8516, mean age 47.4 yrs) were men (76%) and women (24%) with at least 1 examination at the Cooper Clinic. Mailback surveys were conducted in 1990, 1995, and 1999. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale on the 1990 and 1995 surveys, and incident CVD was assessed on the 1995 and 1999 surveys. The average follow-up was 7.9 (SD 1.9) yrs. Severity of symptoms was grouped into the following categories: few or no (CES-D=0–9); moderate (10–15); or severe (≥ 16).
Separate logistic regression analyses adjusting for age, gender, and survey year are in the table.
Depressive symptoms increase the risk for development of CVD, but having depressive symptoms and another CVD risk factor further increases risk, particularly when symptoms are severe. Supported in part by NIMH 57031 and NIA AG06945.