Depression and onset of cardiovascular disease in the US middle-aged and older adults

Abstract

Objectives: To examine the relationship between depression and onset of cardiovascular disease (CVD) among the US middle-aged and older adults.

Methods: The study sample came from 1992–2010 waves of the Health and Retirement Study, a nationally representative longitudinal survey, consisting of 8597 community-dwelling adults aged 51–61 years old in 1992 with no CVD history. A score of ≥3 on the 8-item Center for Epidemiologic Studies Depression Scale was used to define clinically relevant depressive symptoms. Kaplan–Meier estimator and Cox proportional hazards model were performed to examine the association between baseline depressive symptoms and future CVD event. Subgroup analyses were conducted by sex and race/ethnicity.

Results: Compared with their counterparts without clinically relevant depressive symptoms, adults with clinically relevant depressive symptoms in 1992 were 27% (hazard ratio [HR] = 1.27, 95% confidence interval = 1.17–1.39) more likely to report new diagnosis of CVD during the 18 years of follow-up. A significant dose–response relationship was present between severity of depressive symptoms and elevated CVD risk. The adjusted HRs for males and Hispanics appeared moderately larger than for their female and non-Hispanic white or African American counterparts, although the differences were not statistically significant.

Conclusion: Holistic promotion of mental health through prevention, education, treatment, and rehabilitation is warranted to reduce CVD risk in the US middle-aged and older population.

Keywords:

• depression
• cardiovascular disease
• health and retirement study

Disclosure statement

No potential conflict of interest was reported by the authors.