Journal
PLOS ONE
Volume 11, Issue 4, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0153838
Keywords
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Categories
Funding
- National Institute for Health Research [RP-PG-0407-10314]
- Wellcome Trust [086091/Z/08/Z, MR/K006584/1]
- Medical Research Council Prognosis Research Strategy (PROGRESS) Partnership [G0902393/99558]
- Medical Research Council
- Arthritis Research UK
- British Heart Foundation
- Cancer Research UK
- Chief Scientist Office
- Economic and Social Research Council
- Engineering and Physical Sciences Research Council
- National Institute for Health Research
- National Institute for Social Care and Health Research
- Alzheimer Scotland
- University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative [G0700704/ 84698]
- BBSRC
- EPSRC
- ESRC
- MRC
- UCL Provost's Strategic Development Fund Fellowship
- NIHR Doctoral Fellowship [DRF-2009-02-50]
- Medical Research Council [K013351]
- National Heart, Lung and Blood Institute [HL36310]
- National Institute of Aging [AG034454]
- NIHR
- National Institutes of Health Research (NIHR) [DRF-2009-02-50] Funding Source: National Institutes of Health Research (NIHR)
- ESRC [ES/L007517/1, ES/J023299/1] Funding Source: UKRI
- MRC [MR/K013351/1, MR/L01629X/1] Funding Source: UKRI
- British Heart Foundation [RG/13/2/30098] Funding Source: researchfish
- Economic and Social Research Council [ES/J023299/1, ES/L007517/1] Funding Source: researchfish
- Medical Research Council [MR/K006584/1, MR/L01629X/1, MR/K013351/1, MR/K026992/1] Funding Source: researchfish
- National Institute for Health Research [DRF-2009-02-50, RP-PG-0407-10314] Funding Source: researchfish
- Stroke Association [TSA2008/05] Funding Source: researchfish
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Background Depression is associated with coronary heart disease and stroke, but associations with a range of pathologically diverse cardiovascular diseases are not well understood. We examine the risk of 12 cardiovascular diseases according to depression status (history or new onset). Methods Cohort study of 1,937,360 adult men and women, free from cardiovascular disease at baseline, using linked UK electronic health records between 1997 and 2010. The exposures were new-onset depression (a new GP diagnosis of depression and/or prescription for antidepressants during a one-year baseline), and history of GP-diagnosed depression before baseline. The primary endpoint was initial presentation of 12 cardiovascular diseases after baseline. We used disease-specific Cox proportional hazards models with multiple imputation adjusting for cardiovascular risk factors (age, sex, socioeconomic status, smoking, blood pressure, diabetes, cholesterol). Results Over a median [IQR] 6.9 [2.1-10.5] years of follow-up, 18.9% had a history of depression and 94,432 incident cardiovascular events occurred. After adjustment for cardiovascular risk factors, history of depression was associated with: stable angina (Hazard Ratio = 1.38, 95% CI 1.32-1.45), unstable angina (1.70, 1.60-1.82), myocardial infarction (1.21, 1.16-1.27), unheralded coronary death (1.23, 1.14-1.32), heart failure (1.18, 1.13-1.24), cardiac arrest (1.14, 1.03-1.26), transient ischemic attack (1.31, 1.25-1.38), ischemic stroke (1.26, 1.18-1.34), subarachnoid haemorrhage (1.17, 1.01-1.35), intracerebral haemorrhage (1.30, 1.17-1.45), peripheral arterial disease (1.24, 1.18-1.30), and abdominal aortic aneurysm (1.12,1.01-1.24). New onset depression developed in 2.9% of people, among whom 63,761 cardiovascular events occurred. New onset depression was similarly associated with each of the 12 diseases, with no evidence of stronger associations compared to history of depression. The strength of association between depression and these cardiovascular diseases did not differ between women and men. Conclusion Depression was prospectively associated with cardiac, cerebrovascular, and peripheral diseases, with no evidence of disease specificity. Further research is needed in understanding the specific pathophysiology of heart and vascular disease triggered by depression in healthy populations.
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