Abstract 10204: Depressive Symptoms, Positive Affect and Risk of Atrial Fibrillation in Women
Introduction: Depressive symptoms have been associated with ventricular arrhythmias and sudden death; whether they are associated with atrial arrhythmias is unknown. Positive and negative affect, in particular, are increasingly appreciated to be unique predictors of events.
Methods: We evaluated the relationship of depressive symptoms, and symptoms of positive and negative affect, to atrial fibrillation (AF) among female health professionals in the Women's Health Study. At the 60 month visit, depressive symptoms were assessed with the Mental Health Index (MHI-5). Items asked how often participants felt down, downhearted and blue, calm and peaceful, nervous, or happy, on a 6 point Likert scale. MHI-5<53 designated the depressed group, reports of feeling down or blue were used to measure negative affect, and reported happiness was used to measure positive affect. Incident AF was assessed annually and verified through medical records including ECGs. Proportional hazards models adjusted for age, race, body mass index, hypertension, diabetes, hypercholesterolemia, smoking, alcohol intake, and physical activity.
Results: Among 31187 women (age 59+7 years) without history of cardiovascular disease or AF, 2088 (6.8%) had MHI-5 scores indicative of depression, 3052 women (9.8%) reported negative affect (some or more of past 4 weeks feeling so down nothing could cheer them up) and 29970 (96.1%) reported positive affect (some or more of past 4 weeks feeling happy). The latter two scores were moderately correlated (r=−0.53, P <0.01). During follow-up of 86+13 months, there were 620 cases of AF. Depressive symptoms in general (HR=1.00, 95% CI 0.71–1.42) and negative affect (HR 0.89, 95% CI 0.66–1.20) specifically were not associated with AF in multivariable models. However, lack of positive affect was associated with increased risk of AF in multivariable models with (HR 1.67, 95% CI 1.14–2.42) and without (HR 1.51, 95% CI 1.06–2.15) inclusion of negative affect.
Conclusions: In this prospective study of women without known cardiovascular disease, depressive symptoms were unrelated to AF risk, but lack of positive affect was significantly associated. The unique biological substrate of positive affect should be further explored to understand this association.
- © 2010 by American Heart Association, Inc.