Relationship of depressive symptoms with arterial stiffness and carotid atherosclerotic burden in the Corinthia study

Background: It has been long hypothesized that emotional factors and depression may play role in the development of cardiovascular diseases. Aim: The aim of this study was to examine the association between depression, arterial stiffness and atheromatic burden in carotid arteries. Design and methods: Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40-99 years, inhabitants of the homonym region of Greece. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity was used to evaluate arterial stiffness. The Zung Self-Rating Depression Scale was used to evaluate depressive symptoms in subjects <65 years and the Geriatric Depression Scale in those >65 years. Results: In this analysis, we included data from 1510 participants. In older subjects (i.e. >65 years), maximum IMT was significantly increased in subjects with depression compared to those without (1.57 +/- 0.97 mm vs. 1.74 +/- 1.05 mm, P = 0.04). Similarly, the prevalence of atheromatic plaques was higher in subjects with depression (46% vs. 34%, P = 0.005). In the younger subgroup (<65years), there was no difference in mean and maximum IMT. Pulse wave velocity was found higher in the presence of depression (8.35 +/- 2.36m/s vs. 7.88 +/- 1.77m/s, P = 0.007). No differences emerged for the rest of the variables assessed in the individual subgroups. Conclusions: There is an age-dependent association between depression, arterial stiffness and carotid atheromatic burden highlighting the interplay between cardiovascular diseases and emotional status.