Abstract 13046: Depressed Rural Residents are at High Risk of Cardiovascular Disease

Abstract

Background: Depression is a known predictor of cardiovascular disease (CVD) in the general population. The association depression and CVD risk has not been examined in rural Kentucky where CVD risk rates are among the highest in the nation, and where mental health is the poorest. The purpose of this study was to determine whether depression predicts CVD risk factors (i.e., body mass index [BMI], lipids, smoking, hypertension, smoking, non-healthy behaviors) in rural Kentucky.

Methods: Adult residents in rural Kentucky participated in screening for depression using the Patient Health Questionnaire (PHQ-9). Individuals who scored above 9 of the PHQ-9 score were considered to be depressed. They completed physical assessment to assess CVD risk factors including BMI, smoking status, and blood lipid profiles. Unhealthy behaviors were assessed using the modified MOS-Specific Adherence Scale. Unhealthy behaviors were defined as the response, ‘none of the time’ on the 4-point Likert scale for each heart healthy behavior. Logistic regressions were used to determine predictability of depression for each CVD risk factor while controlling for age and gender.

Results: Of the 1057 participants (mean age 53 ±15 years; 74% female), 18.2% were depressed. Depressed adults were more likely to be obese (OR = 1.7, 95% CI 1.2 - 2.3, p = .002), a smoker (OR = 1.8, 95% CI 1.1 - 2.9, p = .012), had lower HDL (<40mg/dL; OR = 1.5, 95% CI 1.1-2.2, p = .011) and higher triglyceride levels (> 200mg/dL; OR = 1.4, 95% CI 1.0 - 1.9, p = .043). They were less likely to report consuming a diet low in total fat; OR = 1.6, 95% CI 1.1 - 2.3, p = .009), low in saturated fats/transfats (OR = 1.8, 95% CI 1.3 - 2.6, p = .001), high in whole grains (OR = 2.1, 95% CI 1.5 - 3.1, p < .001), with 5 or more servings of fruit/vegetables (OR = 1.6, 95% CI 1.1 - 2.3, p =.01), or low in salt (OR = 1.7, 95% CI 1.2 - 2.4, p = .005). They were also less likely to exercise regularly (OR = 1.9, 95% CI 1.4 - 2.8, p = .001), engage in stress management (OR = 2.6, 95% CI 1.6 - 4.3, p < .001).

Conclusion: Depressed rural adults were more likely to have CVD risk factors and engage in non-heart healthy behaviors than non-depressed adults. Assessment and management of depression should be included in lifestyle interventions aimed at improving cardiovascular health in rural adults.