Does depressed persons with non-cardiovascular morbidity have a higher risk of CVD? A population-based cohort study in Sweden

• Published in: BMC cardiovascular disorders Vol. 19; no. 1; pp. 260 - 8
• Main Authors: Almas, Aysha, Moller, Jette, Iqbal, Romaina, Lundin, Andreas, Forsell, Yvonne
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.11.2019; BioMed Central; BMC
• Subjects: Adult; Age; Alcohol use; Arthritis; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - psychology; Cohort analysis; Comorbidity; Depression; Depression (Mood disorder); Depression - diagnosis; Depression - epidemiology; Depression - psychology; Diabetes; Diabetes mellitus; Female; Health; Health risk assessment; Heart attacks; Heart failure; Humans; Hypertension; Longitudinal Studies; Major depressive disorder; Male; Medical research; Medicin och hälsovetenskap; Mental depression; Mental disorders; Mental health; Metabolism; Middle Aged; Morbidity; Non-cardiovascular morbidity; Population studies; Population-based studies; Prevalence; Prognosis; Questionnaires; Risk Assessment; Risk Factors; Stroke; Sweden - epidemiology; Time Factors; Young Adult; Sweden; Depression; Cardiovascular diseases; Non-cardiovascular morbidity; Morbidity
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-019-1252-7

Depression often co-exists with non-cardiovascular morbid conditions. Whether this comorbidity increases the risk of cardiovascular disease has so far not been studied. Thus, the aim of this study was to determine if non-cardiovascular morbidity modifies the effect of depression on future risk of CVD. Data was derived from the PART study (acronym in Swedish for: Psykisk hälsa, Arbete och RelaTioner: Mental Health, Work and Relationships), a longitudinal cohort study on mental health, work and relations, including 10,443 adults (aged 20-64 years). Depression was assessed using the Major Depression Inventory (MDI) and self-reported data on non-cardiovascular morbidity was assessed in 1998-2000. Outcomes of CVD were assessed using the National Patient Register during 2001-2014. Both depression (HR 1.5 (95% CI, 1.1, 2.0)) and non-cardiovascular morbidity (HR 2.0 (95% CI, 1.8, 2.6)) were associated with an increased future risk of CVD. The combined effect of depression and non-cardiovascular comorbidity on future CVD was HR 2.1 (95%, CI 1.3, 3.4) after adjusting for age, gender and socioeconomic position. Rather similar associations were seen after further adjustment for hypertension, diabetes and unhealthy lifestyle factors. Persons affected by depression in combination with non-cardiovascular morbidity had a higher risk of CVD compared to those without non-cardiovascular morbidity or depression alone.