Abstract 15731: Time Course of Depression and Risk of Ischemic Heart Disease in a Community-Based Cohort
Introduction: Although depression is associated with increased risk of ischemic heart disease in the general population, no studies have examined if cardiovascular risk is reduced after depression resolves. Long-standing, persistent depression may also confer higher risk than new-onset depression. We tested the hypothesis that persistent depression carries the highest IHD risk, followed by new-onset, and then remitted depression.
Methods: We studied 2129 community-based people aged 32-83 years without known cardiovascular disease from NHANES I (1971-75) who were assessed for depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and then re-assessed during the 1982-84 follow-up. Incident IHD events (hospitalization and death) were monitored until 1993. Depression was defined as a CES-D score ≥ 16. Cox proportional hazards models were used to estimate the RR of IHD for persistent depression (depressed at both time points), new depression (depressed at follow-up only), and remitted depression (depressed at baseline only) compared to no depression.
Results: The mean ± SD age was 44.8 ± 13.1 years, and 57% were women. In a median follow-up time of 10.6 years, 114 IHD events occurred. In age, sex, and race adjusted analysis, the RR of IHD was significantly elevated for persistent depression (RR 2.1, p=0.02), but not new-onset (RR 1.4, p=0.33) or remitted (RR 1.1, p=0.91) depression. Multivariable adjustment for CVD risk factors minimally affected the association between persistent depression and IHD (see table). No significant interactions between depression and age or sex were found.
Conclusion: Persistent depression, possibly a proxy for clinical depression, may be particularly cardiotoxic for IHD. Remitted depression, on the other hand, is not associated with IHD, supporting the possibility that improvement in depressive symptoms may translate into decreased IHD.
- © 2011 by American Heart Association, Inc.