Depressive Symptoms Linked to Risk for Incident Heart Failure in Black Adult Patients


Sex-distinct associations among symptoms of depression and incident heart failure (HF) have been reported amongst Black adults, with a greater threat observed amongst Black girls. These findings had been published in the Journal of the American Heart Association.

A secondary evaluation of Black patients from the single-internet site, neighborhood-primarily based Jackson Heart Study was carried out. The original JHS study cohort comprised men and women who resided in the Jackson, Mississippi, metropolitan location and was made to discover threat things for cardiovascular illness (CVD).

Recognizing that sparse information are out there from racial minorities and that depression is underrecognized and undertreated in the Black population, the investigators of the study sought to evaluate the connection amongst baseline depressive symptoms, incident HF, and all-result in mortality across 10 years. Participants from the Jackson Heart Study with no history of HF at baseline had been integrated in the secondary evaluation.


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A total of 2651 men and women had been enrolled in the final analytic sample. The participants had been median aged 53 years and 63.9% had been girls. Cox proportional hazards models had been used to examine whether or not the threat for incident HF or mortality varied according to clinically considerable depressive symptoms at baseline (Center for Epidemiological Studies–Depression [CES-D] scores of ≥16 vs &lt16). Self-reported illness and clinical measurement throughout baseline examination had been used to receive participants’ initial HF status.

All of the participants completed a baseline examination among 2000 and 2004, which includes health-related history and physical examination survey of demographic and socioeconomic qualities and life-style things (ie, smoking status, height/weight, alcohol use disorder, physical activity) blood and urine evaluation and CVD assessment.

The major study outcomes integrated HF hospitalization and all-result in mortality and each outcomes had been time-varying. The time to hospitalization outcome classification started on January 1, 2005, which was when HF hospitalization surveillance was initiated in the Jackson Heart Study cohort. Further, time to death was calculated from the date of every baseline examination.

Overall, 20.3% of the participants reported higher levels of depressive symptoms. Of these men and women, 71.% had been girls, and 181 situations of HF had been reported (cumulative incidence, .06% 95% CI, .05%-.07%). The cumulative incidence of all-result in mortality was .05% amongst 293 situations (95% CI, .04%-.05%).

Results of the study showed that the cumulative incidence of HF was considerably greater amongst these with higher vs low levels of depressive symptoms (.07% 95% CI, .05%-.09% vs .05% 95% CI, .04%-.06%, respectively P =.030). In contrast, no considerable distinction in the cumulative incidence of all-result in mortality was observed among these with higher vs low levels of depressive symptoms (.04% 95% CI, .03%-.06% vs .05% 95% CI, .04%-.06%, respectively P =.73).

In the unadjusted model, participants with higher depressive symptoms seasoned a 43% considerably higher threat for HF (P =.035). Although the connection persisted with demographic and HF threat things, it was attenuated by life-style things. Based on sex, the unadjusted hyperlink among depressive symptoms and HF persisted for girls only

(P =.039). Further, in the totally adjusted model, a 53% higher threat for HF was reported amongst these girls with higher levels of depressive symptoms (P =.043).

A important limitation of the present study is the reality that while the CES-D scale was made to measure the present level of depressive symptoms, it did not capture sufficiently the characteristics necessary for a diagnosis of important depressive disorder.

“…in a sample of Black adults, high depressive symptoms were associated with risk of incident HF, which persisted after multivariable adjustment for clinical risk factors, but was eliminated after controlling for lifestyle factors,” the researchers wrote. “Future work is merited concerning changes in the sex-specific burden of depression over time and testing of algorithms for assessing and monitoring depression status, and for treating depression, as potential strategies to mitigate the associated risk of HF among Black men and women.”

Disclosure: Some of the study authors have declared affiliations with biotech, pharmaceutical, and/or device firms. Please see the original reference for a complete list of authors’ disclosures. 

Reference

Gaffey AE, Cavanagh CE, Rosman L, et al. Depressive symptoms and incident heart failure in the Jackson Heart Study: differential risk among Black men and women. J Am Heart Assoc. Published on the web February 22, 2022. doi:10.1161/JAHA.121.022514

This write-up initially appeared on The Cardiology Advisor



Originally published in www.psychiatryadvisor.com