Article

Relationships Between Cardiovascular Disease Risk Factors and Depressive Symptoms as Predictors of Cardiovascular Disease Events in Women

Psychology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA.
Journal of Women's Health (Impact Factor: 1.9). 02/2012; 21(2):133-9. DOI: 10.1089/jwh.2011.2787
Source: PubMed

ABSTRACT Modifiable risk factors for cardiovascular disease (CVD) account for much of the variability in CVD outcomes and are also related to psychosocial variables. There is evidence that depression can undermine the treatment and advance the progression of CVD risk factors, suggesting that CVD risk factor relationships with CVD events may differ among those with depression.
This study tracked CVD events and mortality over a median of 5.9 years among a prospective cohort of 620 women (mean age 59.6 years [11.6]) completing a diagnostic protocol including coronary angiography and CVD risk factor assessment. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). The study outcome was combined cardiovascular mortality and events.
Over the follow-up interval, 16.1% of the sample experienced one or more of the cardiovascular outcomes. In separate Cox regression models adjusting for age, education history, ethnicity, and coronary angiogram scores, we observed statistically significant CVD risk factor × BDI score interactions for diabetes, smoking, and waist-hip ratio factors. Simple effect analyses indicated that diabetes and smoking status were more strongly associated with cardiovascular outcomes among participants with lower BDI scores, whereas waist-hip ratio values predicted outcomes only among those with higher BDI scores.
These results suggest that the relationship between modifiable CVD risk factors and CVD outcomes may vary with depression status in clinical samples of women. This evidence augments prior research by demonstrating that depression may influence CVD risk jointly with or independent of CVD risk factors. It also provides further support for the inclusion of depression assessment in cardiovascular clinic settings.

1 Follower
 · 
185 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diseases once associated with older adulthood, type 2 diabetes and cardiovascular disease, are increasingly diagnosed in children and adolescents. Interventions designed to assist adults in modifying dietary and physical activity habits have been shown to help prevent the development of type 2 diabetes and cardiovascular disease in adults. Given the unfortunate rise in both of these diseases in pediatric populations, it is increasingly important to begin prevention efforts in childhood or prenatally. There is strong empirical support for utilizing lifestyle interventions to prevent these diseases in adults; it is not clear whether the same holds true for pediatric populations. The present review examines lifestyle management efforts to prevent type 2 diabetes and cardiovascular disease in children across socioecological levels. Recommendations are made for expanding the traditional focus of lifestyle interventions from dietary and physical activity behaviors to target additional risks for these diseases such as smoking and depression in youth.
    Current Diabetes Reports 12/2014; 14(12):557. DOI:10.1007/s11892-014-0557-2 · 3.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The transformation of cardiovascular disease prevention for women must address that a number of nontraditional atherosclerotic cardiovascular disease risk factors are unique to or predominant in women. As well, many traditional atherosclerotic cardiovascular disease risk factors impart differential risks for women and for men. Gender-specific risk assessment and management have the potential to improve atherosclerotic cardiovascular disease outcomes in women. © 2014 S. Karger AG, Basel.
    Cardiology 12/2014; 130(1):62-68. DOI:10.1159/000370018 · 2.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Describe prevalence and relationships to cardiovascular morbidity of depression, anxiety and medication use among Hispanic/Latinos of different ethnic backgrounds. Methods Cross-sectional analysis of 15,864 men and women ages 18-74 in the population-based Hispanic Community Health Study/Study of Latinos .Depressive and anxiety symptoms were assessed with shortened Center for Epidemiological Studies Depression scale and Spielberger Trait Anxiety Scale. Results Prevalence of high depressive symptoms ranged from low of 22.3% (95%CI: 20.4-24.3) to high of 38.0% (95%CI: 35.2-41.0) among those of Mexican or Puerto Rican background respectively. Adjusted odds ratios for depression rose monotonically with number of CVD risk factors from 1.46 (95%CI: 1.18, 1.75) for those with no risk factors to 4.36 (95%CI: 2.47, 7.70) for those with 5 risk factors. Antidepressant medication was used by 5% with striking differences between those with and without history of CVD (15.4% and 4.6% respectively) and between insured (8.2%) and uninsured (1.8%). Conclusions Among US Hispanics/Latinos, high depression and anxiety symptoms varied nearly two-fold by Hispanic background and sex, history of CVD and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population, suggesting under treatment especially among those who had no health insurance.
    Annals of Epidemiology 09/2014; 24(11). DOI:10.1016/j.annepidem.2014.09.003 · 2.15 Impact Factor

Full-text

Download
129 Downloads
Available from
May 28, 2014

Similar Publications