期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 39, 期 4, 页码 1016-1024出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyq050
关键词
Depression; coronary heart disease; cerebrovascular disease
资金
- Academy of Finland [117604, 124271, 124322, 128089, 129262]
- Association for Promotion of Occupational Health
- BUPA Foundation, UK
- National Heart, Lung and Blood Institute, NIH, US [R01HL036310-20A2]
- European Science Foundation
- National Institute on Aging, NIH [R01AG013196, R01AG034454]
Background The relationship between depression and cerebrovascular disease (CBVD) continues to be debated although little research has compared the predictive power of depression for coronary heart disease (CHD) with that for CBVD within the same population. This study aimed to compare the importance of depression for CHD and CBVD within the same population of adults free of apparent cardiovascular disease. Methods A random sample of 23 282 adults (9507 men, 13 775 women) aged 20-54 years were followed up for 7 years. Fatal and first non-fatal CHD and CBVD events were documented by linkage to the National-hospital-discharge and mortality registers. Results Sex-age-education-adjusted hazard ratio (HR) for CHD was 1.66 [95% confidence interval (CI) 1.24-2.24] for participants with mild to severe depressive symptoms, i.e. those scoring >= 10 on the 21-item Beck Depression Inventory, and 2.04 (1.27-3.27) for those who filled antidepressant prescriptions compared with those without depression markers in 1998, i.e. at study baseline. For CBVD, the corresponding HRs were 1.01 (0.67-1.53) and 1.77 (0.95-3.29). After adjustment for behavioural and biological risk factors these associations were reduced but remained evident for CHD, the adjusted HRs being 1.47 (1.08-1.99) and 1.72 (1.06-2.77). For CBVD, the corresponding multivariable adjusted HRs were 0.87 (0.57-1.32) and 1.52 (0.81-2.84). Conclusions Self-reported depression using a standardized questionnaire and clinical markers of mild to severe depression were associated with an increased risk for CHD. There was no clear evidence that depression is a risk factor for CBVD, but this needs further confirmation.
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