Depressive Symptoms Linked with Greater Risk for CVD

A new study in JAMA Psychiatry reveals that depressive symptoms are associated with an increased risk of incident cardiovascular disease (CVD).

The 21-country population-based cohort study included more than 145,000 individuals (n=145,862; 370 urban centers and 314 rural communities). The researchers looked for four or more self-reported depressive symptoms as indicated on the Short-Form Composite International Diagnostic Interview. The primary outcome of interest was incident CVD, all-cause mortality, and combined either incident CVD or all-cause mortality. Median follow-up was 9.3 years, with the cohort containing 58% male participants.

The results showed that 15,983 participants (11%) reported four or more depressive symptoms at study baseline. In multivariate models, the researchers also reported an association between depression and incident CVD (HR=1.14; 95% CI, 1.05 to 1.24), all-cause mortality (HR-1.17, 95% CI, 1.11 to 1.25), the CVD/mortality outcome (HR=1.18; 95% CI, 1.11 to 1.24), as well as myocardial infarction and noncardiovascular death. As the number of symptoms increase, so did the risk for the combined CVD/mortality outcome, peaking in those with seven symptoms and being the lowest in participants with one symptom. Additionally, they noted that links between having four or more depressive symptoms and the combined outcome were similar across geographical areas, but were strongest in urban communities compared with rural communities (P=0.001 for interaction), as well as in men compared with women (P<0.001 for interaction).

“In this large, population-based cohort study, adults with depressive symptoms were associated with having increased risk of incident CVD and mortality in economically diverse settings, especially in urban areas,” the researchers concluded. “Improving understanding and awareness of these physical health risks should be prioritized as part of a comprehensive strategy to reduce the burden of noncommunicable diseases worldwide.”

According to a press release, lead author Scott Lear, a professor of health sciences at Simon Fraser University, said that the results, showing links between depressive symptoms and the risk for more serious disease, “are timely as experts anticipate an increase in the number of people dealing with mental health issues as a result of the COVID-19 pandemic.”