Adults With Depression Are More Likely to Die From CVD, All Causes

A new study linked depression with cardiovascular disease (CVD)-related and all-cause mortality. The results, which appeared in JAMA Network Open, underscored the need to ramp up public health efforts to improve both mental and cardiovascular health.

In 2020, over 8% of the US population had at least 1 major depression episode. Depression has been linked with numerous adverse outcomes, including CVD and ischemic heart disease (IHD). Understanding the association between depressive symptoms and death from CVD, IHD, and all causes “may be an important step toward defining prevention and treatment strategies for both mood disorders and CVD,” the investigators noted.

While previous studies have focused on the connection between depression and incident CVD or mortality, they included mostly middle-aged or older populations and assessed the presence of depression as a binary variable or utilized a total score that weighed each depression symptom equally.

In this prospective cohort study, researchers used a nationally representative sample of US adults from the National Health and Nutrition Examination Survey (2005 to 2018) with data linked to the National Death Index through 2019. In total, they assessed 23,694 participants. The main outcomes of interest were CVD, IHD, and all-cause mortality. The researchers defined depressive symptoms using Patient Health Questionnaire-9 scores, which categorized symptoms as none or minimal, mild, and moderate to severe. Data analysis took place between March 1 and May 26, 2023.

Public Health Efforts Needed

The study found that 7.2% of US adults had moderate to severe depressive symptoms, and 14.9% had mild depressive symptoms. The researchers observed that participants with mild depressive symptoms had a 35% higher risk of all-cause mortality and a 49% higher risk of CVD-related mortality. They noted that the risk of CVD, IHD, and all-cause mortality was 79%, 121%, and 62% higher, respectively, for those with moderate to severe depressive symptoms compared with those without depression.

“There was a graded positive association between depressive symptoms and mortality,” the researchers wrote. “Public health efforts to improve awareness and treatment of depression and associated risk factors could support a comprehensive, nationwide strategy to reduce the burden of depression.”