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Depression increases the onset of cardiovascular disease over and above other determinants in older primary care patients, a cohort study.

van Marwijk HW, van der Kooy KG, Stehouwer CD, Beekman AT, van Hout HP - BMC Cardiovasc Disord (2015)

Bottom Line: MDD was associated with a hazard ratio of 2.83 (p value 0,004, 95% CI 1.32 to 6.05) for cardiovascular events.After adjustment for cardiovascular medication, the hazard ratio was 2.46 (95% CI 1.14 to 5.30).In a 2-year follow-up period, baseline MDD increased the risk for CVD in older primary care patients compared with controls, over and above well-known cardiovascular risk factors.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice and Elderly Care Medicine, EMGO+ Institute for Health and Health Care Research, VU University Medical Center, Amsterdam, The Netherlands. hwj.vanmarwijk@vumc.nl.

ABSTRACT

Background: To determine if major depressive disorder (MDD) in older primary care patients is an independent risk factor for cardiovascular events.

Methods: A cohort of 143 primary care patients with depression and 139 non-depressed controls without depression (both aged over 55 years, matched for age and gender) from the Netherlands was evaluated for 2 years. MDD was diagnosed according to DSM-IV-criteria. During the follow-up period, information was collected on physical health, depression status and behavioural risk factors. CVD end points were assessed with validated annual questionnaires and were crosschecked with medical records.

Results: Thirty-four participants experienced a cardiovascular event, of which 71% were depressed: 27/134 with MDD (20.1%) and 9/137 controls (6.6%). MDD was associated with a hazard ratio of 2.83 (p value 0,004, 95% CI 1.32 to 6.05) for cardiovascular events. After adjustment for cardiovascular medication, the hazard ratio was 2.46 (95% CI 1.14 to 5.30).

Conclusions: In a 2-year follow-up period, baseline MDD increased the risk for CVD in older primary care patients compared with controls, over and above well-known cardiovascular risk factors.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the recruitment of participants
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Fig2: Flow chart of the recruitment of participants

Mentions: In bivariate analysis between covariates and cardiovascular events in on average 743 days, depression and a history of CVD increased the hazard ratio for cardiovascular events significantly (Table 1). Depression had an unadjusted hazard ratio (HR) for CVD events in older general practice patients of 2.83 (95 % confidence interval (CI) 1.32 to 6.05). As the MADRS score was highly correlated with depression status (Pearson correlation 0.79), we excluded it from the analyses. Only CVD medication at baseline was significantly associated with both baseline depression status and outcome and remained in the model. After adjustment for CVD medication, the hazard ratio decreased slightly to 2.46 (95 % CI 1.14 to 5.30). Other models showed similar slight reductions in HR for depression on cardiovascular events. Survival curves according to the adjusted Cox model are shown in Fig. 2. No evidence for effect modification between prior CVD status and depression was seen.Fig. 2


Depression increases the onset of cardiovascular disease over and above other determinants in older primary care patients, a cohort study.

van Marwijk HW, van der Kooy KG, Stehouwer CD, Beekman AT, van Hout HP - BMC Cardiovasc Disord (2015)

Flow chart of the recruitment of participants
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4493948&req=5

Fig2: Flow chart of the recruitment of participants
Mentions: In bivariate analysis between covariates and cardiovascular events in on average 743 days, depression and a history of CVD increased the hazard ratio for cardiovascular events significantly (Table 1). Depression had an unadjusted hazard ratio (HR) for CVD events in older general practice patients of 2.83 (95 % confidence interval (CI) 1.32 to 6.05). As the MADRS score was highly correlated with depression status (Pearson correlation 0.79), we excluded it from the analyses. Only CVD medication at baseline was significantly associated with both baseline depression status and outcome and remained in the model. After adjustment for CVD medication, the hazard ratio decreased slightly to 2.46 (95 % CI 1.14 to 5.30). Other models showed similar slight reductions in HR for depression on cardiovascular events. Survival curves according to the adjusted Cox model are shown in Fig. 2. No evidence for effect modification between prior CVD status and depression was seen.Fig. 2

Bottom Line: MDD was associated with a hazard ratio of 2.83 (p value 0,004, 95% CI 1.32 to 6.05) for cardiovascular events.After adjustment for cardiovascular medication, the hazard ratio was 2.46 (95% CI 1.14 to 5.30).In a 2-year follow-up period, baseline MDD increased the risk for CVD in older primary care patients compared with controls, over and above well-known cardiovascular risk factors.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice and Elderly Care Medicine, EMGO+ Institute for Health and Health Care Research, VU University Medical Center, Amsterdam, The Netherlands. hwj.vanmarwijk@vumc.nl.

ABSTRACT

Background: To determine if major depressive disorder (MDD) in older primary care patients is an independent risk factor for cardiovascular events.

Methods: A cohort of 143 primary care patients with depression and 139 non-depressed controls without depression (both aged over 55 years, matched for age and gender) from the Netherlands was evaluated for 2 years. MDD was diagnosed according to DSM-IV-criteria. During the follow-up period, information was collected on physical health, depression status and behavioural risk factors. CVD end points were assessed with validated annual questionnaires and were crosschecked with medical records.

Results: Thirty-four participants experienced a cardiovascular event, of which 71% were depressed: 27/134 with MDD (20.1%) and 9/137 controls (6.6%). MDD was associated with a hazard ratio of 2.83 (p value 0,004, 95% CI 1.32 to 6.05) for cardiovascular events. After adjustment for cardiovascular medication, the hazard ratio was 2.46 (95% CI 1.14 to 5.30).

Conclusions: In a 2-year follow-up period, baseline MDD increased the risk for CVD in older primary care patients compared with controls, over and above well-known cardiovascular risk factors.

No MeSH data available.


Related in: MedlinePlus