Does Depressed Persons with Non-cardiovascular Morbidity Have a Higher Risk of CVD? A Population-based Cohort Study in Sweden

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2019 Nov 23

PMID 31752710

Citations 2

Authors

Aysha Almas

Jette Moller

Romaina Iqbal

Andreas Lundin

Yvonne Forsell

Affiliations

Soon will be listed here.

Abstract

Background: Depression often co-exists with non-cardiovascular morbid conditions. Whether this comorbidity increases the risk of cardiovascular disease has so far not been studied. Thus, the aim of this study was to determine if non-cardiovascular morbidity modifies the effect of depression on future risk of CVD.

Methods: Data was derived from the PART study (acronym in Swedish for: Psykisk hälsa, Arbete och RelaTioner: Mental Health, Work and Relationships), a longitudinal cohort study on mental health, work and relations, including 10,443 adults (aged 20-64 years). Depression was assessed using the Major Depression Inventory (MDI) and self-reported data on non-cardiovascular morbidity was assessed in 1998-2000. Outcomes of CVD were assessed using the National Patient Register during 2001-2014.

Results: Both depression (HR 1.5 (95% CI, 1.1, 2.0)) and non-cardiovascular morbidity (HR 2.0 (95% CI, 1.8, 2.6)) were associated with an increased future risk of CVD. The combined effect of depression and non-cardiovascular comorbidity on future CVD was HR 2.1 (95%, CI 1.3, 3.4) after adjusting for age, gender and socioeconomic position. Rather similar associations were seen after further adjustment for hypertension, diabetes and unhealthy lifestyle factors.

Conclusion: Persons affected by depression in combination with non-cardiovascular morbidity had a higher risk of CVD compared to those without non-cardiovascular morbidity or depression alone.

Citing Articles

Psychiatric disorders and subsequent risk of cardiovascular disease: a longitudinal matched cohort study across three countries.

Shen Q, Mikkelsen D, Luitva L, Song H, Kasela S, Aspelund T EClinicalMedicine. 2023; 61:102063.

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Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study.

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References

Almas A, Forsell Y, Iqbal R, Janszky I, Moller J . Severity of Depression, Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort. PLoS One. 2015; 10(10):e0140742. PMC: 4607409. DOI: 10.1371/journal.pone.0140742. View

Sharma A, Zhao X, Hammill B, Hernandez A, Fonarow G, Felker G . Trends in Noncardiovascular Comorbidities Among Patients Hospitalized for Heart Failure: Insights From the Get With The Guidelines-Heart Failure Registry. Circ Heart Fail. 2018; 11(6):e004646. DOI: 10.1161/CIRCHEARTFAILURE.117.004646. View

Metra M, Zaca V, Parati G, Agostoni P, Bonadies M, Ciccone M . Cardiovascular and noncardiovascular comorbidities in patients with chronic heart failure. J Cardiovasc Med (Hagerstown). 2010; 12(2):76-84. DOI: 10.2459/JCM.0b013e32834058d1. View

Battle D . Diagnostic and Statistical Manual of Mental Disorders (DSM). Codas. 2014; 25(2):191-2. DOI: 10.1590/s2317-17822013000200017. View

Fisher E, Chan J, Nan H, Sartorius N, Oldenburg B . Co-occurrence of diabetes and depression: conceptual considerations for an emerging global health challenge. J Affect Disord. 2012; 142 Suppl:S56-66. DOI: 10.1016/S0165-0327(12)70009-5. View

Lee D, Austin P, Rouleau J, Liu P, Naimark D, Tu J . Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA. 2003; 290(19):2581-7. DOI: 10.1001/jama.290.19.2581. View

Thurston R, El Khoudary S, Derby C, Barinas-Mitchell E, Lewis T, McClure C . Low socioeconomic status over 12 years and subclinical cardiovascular disease: the study of women's health across the nation. Stroke. 2014; 45(4):954-60. PMC: 3981101. DOI: 10.1161/STROKEAHA.113.004162. View

Roest A, Zuidersma M, de Jonge P . Myocardial infarction and generalised anxiety disorder: 10-year follow-up. Br J Psychiatry. 2012; 200(4):324-9. DOI: 10.1192/bjp.bp.111.103549. View

Forsell Y . The Major Depression Inventory versus Schedules for Clinical Assessment in Neuropsychiatry in a population sample. Soc Psychiatry Psychiatr Epidemiol. 2005; 40(3):209-13. DOI: 10.1007/s00127-005-0876-3. View

10.

Ludvigsson J, Andersson E, Ekbom A, Feychting M, Kim J, Reuterwall C . External review and validation of the Swedish national inpatient register. BMC Public Health. 2011; 11:450. PMC: 3142234. DOI: 10.1186/1471-2458-11-450. View

11.

Katon W . Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biol Psychiatry. 2003; 54(3):216-26. DOI: 10.1016/s0006-3223(03)00273-7. View

12.

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

13.

Van der Kooy K, van Hout H, Marwijk H, Marten H, Stehouwer C, Beekman A . Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry. 2007; 22(7):613-26. DOI: 10.1002/gps.1723. View

14.

Hamer M, Batty G, Seldenrijk A, Kivimaki M . Antidepressant medication use and future risk of cardiovascular disease: the Scottish Health Survey. Eur Heart J. 2010; 32(4):437-42. PMC: 3038336. DOI: 10.1093/eurheartj/ehq438. View

15.

Rushton C, Satchithananda D, Jones P, Kadam U . Non-cardiovascular comorbidity, severity and prognosis in non-selected heart failure populations: A systematic review and meta-analysis. Int J Cardiol. 2015; 196:98-106. PMC: 4518480. DOI: 10.1016/j.ijcard.2015.05.180. View

16.

Cuijpers P, van Straten A, Warmerdam L . Problem solving therapies for depression: a meta-analysis. Eur Psychiatry. 2006; 22(1):9-15. DOI: 10.1016/j.eurpsy.2006.11.001. View

17.

Wang P, Avorn J, Brookhart M, Mogun H, Schneeweiss S, Fischer M . Effects of noncardiovascular comorbidities on antihypertensive use in elderly hypertensives. Hypertension. 2005; 46(2):273-9. DOI: 10.1161/01.HYP.0000172753.96583.e1. View

18.

Findley P, Shen C, Sambamoorthi U . Multimorbidity and persistent depression among veterans with diabetes, heart disease, and hypertension. Health Soc Work. 2011; 36(2):109-19. DOI: 10.1093/hsw/36.2.109. View

19.

Deyo R, Centor R . Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chronic Dis. 1986; 39(11):897-906. DOI: 10.1016/0021-9681(86)90038-x. View

20.

Schmidt M, Jacobsen J, Lash T, Botker H, Sorensen H . 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study. BMJ. 2012; 344:e356. PMC: 3266429. DOI: 10.1136/bmj.e356. View