Study information published in the Journal of Psychosomatic Research identified an elevated threat for cardiovascular illness in patients with depression. The association was most substantial in patients with clinically relevant depressive symptoms. Patients with controlled depression did not have elevated cardiovascular threat compared with manage participants.
This retrospective study enrolled patients with a main care encounter among 2016 and 2018 at participating centers in Minnesota and Wisconsin. Patients had been retained for the present evaluation if they had completed the Patient Health Questionnaire-9 (PHQ-9) in the year prior to their care encounter. Per PHQ-9 scores, patients had been classified into the following groups: (1) no depression (2) depression diagnosis with at the moment controlled symptoms and (3) active depression.
Demographic information, mental wellness information, and cardiovascular threat information had been abstracted from electronic healthcare records. Cardiovascular threat was calculated working with 2 equations: 1 estimated the likelihood of getting a fatal or nonfatal atherosclerotic CVD occasion in the next 10 years the other estimated the 30-year threat. Risk equations incorporated demographic information and threat things, like blood stress, lipid levels, diabetes status, smoking status, and body mass index (BMI). Logistic regression models had been used to estimate total and distinct cardiovascular threat amongst patients with depression compared with patients devoid of depression.
The study cohort comprised 70,980 patients: 18,267 (24.1%) with existing depression 33,383 (47.%) with controlled depression and 19,330 (27.2%) with no depression. Patients with existing depression had been younger, more typically ladies, and significantly less typically White compared with other patient groups (all P <.001).
In analyses adjusted for age, sex race/ethnicity, and insurance coverage form, patients with existing depression had a substantially elevated 30-year threat for cardiovascular events compared with patients with controlled depression (odds ratio [OR], 1.1.18 95% CI, 1.13-1.24) and patients devoid of depression (OR, 1.56 95% CI, 1.48-1.65). The 10-year threat was also substantially elevated compared with patients devoid of depression (OR, 1.56 95% CI, 1.48-1.65), even though not compared with patients with controlled depression.
Patients with existing depression had been also more probably to have particular cardiovascular threat things. Specifically, patients with existing depression had been more probably to have a existing diagnosis of coronary heart illness or cardiovascular illness than their counterparts devoid of existing depression. Patients with existing depression had substantially greater triglycerides and reduced higher-density lipoprotein than patients with controlled depression or no depression. Current depression was additional linked with greater BMI, higher odds of existing smoking, and higher odds of a existing diabetes mellitus diagnosis.
These outcomes recommend that the therapy of depression, in addition to uncontrolled cardiovascular threat things, is crucial in mitigating cardiovascular threat. Study limitations include things like the cross-sectional design and style and the exclusion of patients devoid of PHQ-9 information, which could have introduced choice bias to the depression cohort.
“[Further] clinical and research efforts are needed to ascertain mechanisms, determine causality, further examine moderators…and establish best approaches for reducing cardiovascular risk in patients with current depression,” the investigators wrote.
Hooker SA, O’Connor PJ, Sperl-Hillen JM, et al. Depression and cardiovascular risk in primary care patients. J Psychosom Res. Published on line April 19, 2022. doi:10.1016/j.jpsychores.2022.110920