Depression and cardiovascular risk in primary care patients.
Cardiovascular disease prevention
Cardiovascular risk
Depression
Primary care
Journal
Journal of psychosomatic research
ISSN: 1879-1360
Titre abrégé: J Psychosom Res
Pays: England
ID NLM: 0376333
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
12
08
2021
revised:
12
04
2022
accepted:
12
04
2022
pubmed:
24
4
2022
medline:
3
6
2022
entrez:
23
4
2022
Statut:
ppublish
Résumé
This study assessed the relationship of both depression diagnosis and clinically significant depressive symptoms with individual cardiovascular risk factors and estimated total cardiovascular risk in primary care patients. This study used a cross-sectional and retrospective design. Patients who had a primary care encounter between January 2016 and September 2018 and completed depression screening (PHQ-9) during the year prior to their appointment (N = 70,980) were included in this study. Data examining estimated total cardiovascular risk, specific cardiovascular risk factors, and relevant clinical diagnoses (including depression diagnosis) were extracted from the electronic health record. Patients were categorized into three groups: no depression (PHQ-9 < 10 and no depression diagnosis), controlled depression (PHQ-9 < 10 with previous depression diagnosis), and current depression (PHQ-9 ≥ 10). Groups were compared on estimated total risk and specific cardiovascular risk factors (e.g., body mass index [BMI], smoking status, lipids, blood pressure, and glucose). In adjusted analyses, patients with current depression (n = 18,267) demonstrated significantly higher 10-year and 30-year cardiovascular risk compared to patients with controlled depression (n = 33,383; 10-year: b = 0.59 [95% CI = 0.44,0.74]; 30-year: OR = 1.32 [95% CI = 1.26,1.39]) and patients without depression (n = 19,330; 10-year: b = 0.55 [95% CI = 0.37,0.73]; 30-year: OR = 1.56 [95% CI = 1.48,1.65]). Except for low-density lipoprotein (LDL), patients with current depression had the greatest cardiovascular risk across specific risk factors. Individuals who had a depression diagnosis and clinically significant depressive symptoms had the greatest cardiovascular risk. Pathways to prevent cardiovascular disease in those with depression might focus on treating depressive symptoms as well as specific uncontrolled cardiovascular risk factors.
Identifiants
pubmed: 35461074
pii: S0022-3999(22)00205-7
doi: 10.1016/j.jpsychores.2022.110920
pmc: PMC9237849
mid: NIHMS1802586
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
110920Subventions
Organisme : NIMH NIH HHS
ID : U19 MH092201
Pays : United States
Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Références
Health Psychol Rev. 2015;9(3):366-78
pubmed: 25739893
Circulation. 2006 Feb 14;113(6):791-8
pubmed: 16461820
JAMA. 2003 Jun 18;289(23):3106-16
pubmed: 12813116
J Am Coll Cardiol. 2014 Sep 9;64(10):959-68
pubmed: 25190228
Yale J Biol Med. 2013 Jun 13;86(2):139-46
pubmed: 23766735
Mol Psychiatry. 2013 Sep;18(9):963-74
pubmed: 23439482
PLoS One. 2012;7(12):e52771
pubmed: 23300767
J Psychosom Res. 2019 Jun;121:14-23
pubmed: 30712815
Asian J Psychiatr. 2013 Dec;6(6):460-72
pubmed: 24309855
Am J Geriatr Psychiatry. 2001 Spring;9(2):169-76
pubmed: 11316621
Eur Heart J. 2006 Dec;27(23):2763-74
pubmed: 17082208
Neurology. 2010 Dec 7;75(23):2063-70
pubmed: 21135381
J Affect Disord. 2019 Jun 1;252:190-200
pubmed: 30986734
Nat Rev Cardiol. 2017 Mar;14(3):145-155
pubmed: 27853162
Sci Rep. 2018 Feb 12;8(1):2861
pubmed: 29434331
Nat Rev Cardiol. 2012 Sep;9(9):526-39
pubmed: 22733213
Ann Occup Environ Med. 2019 Jun 20;31:e10
pubmed: 31543971
Psychosom Med. 2004 May-Jun;66(3):305-15
pubmed: 15184688
Psychol Med. 2020 Oct;50(14):2435-2443
pubmed: 31689377
Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73
pubmed: 24222018
J Gen Intern Med. 2006 Sep;21(9):926-30
pubmed: 16918736
Psychosom Med. 2004 Nov-Dec;66(6):814-22
pubmed: 15564344
Arch Gen Psychiatry. 2004 Oct;61(10):1042-9
pubmed: 15466678
Curr Atheroscler Rep. 2020 Aug 9;22(10):51
pubmed: 32772177
Prev Med. 2021 Jan;142:106378
pubmed: 33346038
Contemp Clin Trials. 2020 Apr;91:105964
pubmed: 32087336
Psychiatr Serv. 2003 May;54(5):682-7
pubmed: 12719498
Arch Gen Psychiatry. 1998 Jul;55(7):580-92
pubmed: 9672048
Eur Heart J Cardiovasc Pharmacother. 2021 Jul 23;7(4):280-286
pubmed: 33200205
Int J Cardiol. 2018 Jul 1;262:99-105
pubmed: 29706397
J Affect Disord. 2013 May 15;148(1):12-27
pubmed: 23415826
BMJ. 2019 Apr 8;365:l835
pubmed: 30962249
Int J Cardiol. 2019 Jun 1;284:90-95
pubmed: 30305238
J Gen Intern Med. 1999 Aug;14(8):461-8
pubmed: 10491229
Eur Heart J. 2014 Jun 1;35(21):1365-72
pubmed: 24282187
JAMA. 2017 Apr 18;317(15):1517
pubmed: 28418490
Scand J Prim Health Care. 2019 Sep;37(3):312-318
pubmed: 31317810
Eur Heart J. 2007 Dec;28(24):2972-84
pubmed: 17984133