AUTHOR=Shen Ruihuan , Zhao Ning , Wang Jia , Guo Peiyao , Shen Shuhui , Liu Donghao , Zou Tong 

TITLE=Association between level of depression and coronary heart disease, stroke risk and all-cause and cardiovascular mortality: Data from the 2005–2018 National Health and Nutrition Examination Survey

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.954563

DOI=10.3389/fcvm.2022.954563

ISSN=2297-055X

ABSTRACT=Research on the association between level of depression and coronary heart disease (CHD), stroke risk and all-cause and cardiovascular mortality are lacking in large-scale or population-based studies incorporating cardiovascular diseases (CVDs) endpoints. We aim to assess the relationship between the level of a person’s depression and their risk of CHD, stroke as well as all-cause and cardiovascular mortality. Utilizing data from the United States National Health and Nutrition Examination Survey (NHANES), a multicycle cross-sectional design and mortality linkage study was conducted. The study sample included 30918 participants aged 20-85 years old during the 2005-2018 period. Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9), with scores of 5, 10, 15, and 20 being the cut-points for mild, moderate, moderately severe, and severe depression, respectively. A series of weighted Logistic regression analyses and Cox proportional hazards models were utilized to examine the relationship between the level of depression with the risk of CHD, stroke, all-cause and cardiovascular mortality. Trend analyses were conducted by entering the level of depression as continuous variable and rerunning the corresponding regression models. Weighted Logistic regression models consistently indicated statistically significant association between level of depression and increased risk of CHD, stroke, and those linear trend tests were statistically significant (P for trend < 0.001). Furthermore, weighted Cox regression analyses consistently indicated that participants who had a more severe degree of depression were at a higher risk of all-cause death, and trend analyses suggested similar results (P for trend < 0.001). And another weighted Cox regression analyses also consistently indicated that excepting for severe depression, the hazard of cardiovascular death were increased with each additional level increase of depression. Our study confirmed that the level of depression was strongly tied to living with CHD, stroke and all-cause and cardiovascular mortality, even after accounting for other factors that could impact risk, including variables of age, gender, ethnicity, income, education, body mass index (BMI), marital and smoking status.