Comorbidity of cardiovascular diseases with mood and anxiety disorder: A population based 4-year study

Aims: Accumulating evidence from Caucasian patients has shown that depression, bipolar and anxiety disorders are associated with an increased risk of cardiovascular diseases (CVD), but reports in the Asian population are limited, and age effect is rarely investigated. This population-based study was carried out to examine and compare the CVD comorbidities among patients with mood and anxiety disorders in different age groups. Method: A 4-year cross-sectional survey was carried out using the Taiwan National Health Insurance Research Database from 2000 to 2003. Results: An average total of 1 031 557 patients with mood and anxiety disorders were enrolled as study participants, including 76 430 cases of major depressive disorder, 41 557 cases of bipolar disorder, and 913 570 cases of anxiety disorder. When compared with the insured population without mood or anxiety disorders (average 21 356 304 people), the average relative risk (RR) of developing ischemic heart disease and hypertensive disorders in 1 031 557 study participants was 2.0 and 2.05, respectively. The highest RR was found in the age group under 20 years (RR = 4.74 and 4.08, respectively), and the lowest RR in the age group equal to or older than 65 years (RR = 0.47 and 0.58, respectively). Conclusions: Taiwanese patients with mood and anxiety disorders experience high cardiovascular morbidity, especially patients with anxiety disorders. Age acted as an important modifier variable that influenced the relationship between mood, anxiety disorder and CVD. This study highlights the need for future research in different age groups, in order to elucidate the causality and the trajectory of developing CVD among patients with mental disorders.