Miscellaneous
Relation Between Depressive Symptoms and Common Carotid Artery Atherosclerosis in American Persons ≥65 Years of Age†

https://doi.org/10.1016/j.amjcard.2006.12.090Get rights and content

Few epidemiologic studies have examined the association between depressive symptoms and atherosclerosis in subjects aged ≥65 years. Most of these studies were cross sectional and could not determine the temporality between depressive symptoms and the development of abnormal common carotid artery (CCA) intima-media thickness (CCA-IMT). To investigate the association between depressive symptoms and CCA atherosclerosis in subjects aged ≥65 years, data from 3,781 participants aged ≥65 years from the Cardiovascular Health Study were analyzed. The presence of depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale, while CCA-IMT as an indicator of CCA atherosclerosis was measured by B-mode carotid ultrasonography. Multivariate generalized estimation equations adjusted for age, gender, race, alcohol intake, blood glucose status, body mass index, and time showed that subjects aged ≥65 years with depressive symptoms had larger CCA-IMTs than those who did not have such symptoms (β = 18.26 μm, SE 8.06, p = 0.03). Using 1,000 and 1,140 μm as cut-off points to exclude participants who had abnormal CCA-IMTs at baseline, the adjusted relative risks and the corresponding 95% confidence intervals of developing abnormal CCA-IMT over 3 years were 1.30 (95% confidence interval 1.10 to 1.44) and 1.21 (95% confidence interval 1.00 to 1.46), respectively. Similar results were obtained after excluding participants with prevalent cardiovascular disease at baseline. In conclusion, these data indicate that depressive symptoms are associated with the development of atherosclerosis in subjects aged ≥65 years.

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Methods

The Cardiovascular Health Study (CHS) is an observational study of risk factors associated with the development and progression of CHD and stroke in subjects aged ≥65 years.10 This study is the most extensive yet undertaken by the National Heart, Lung, and Blood Institute to study cardiovascular disease exclusively in subjects aged ≥65 years. Random samples were obtained from the Health Care Financing Administration Medicare lists in 4 geographic areas (Forsyth County, North Carolina;

Results

The characteristics of the study participants at baseline are presented in Table 1. Those with depressive symptoms were more likely to be women, nonwhite, and alcohol drinkers than those without depressive symptoms (p <0.05). Histories of CHD were more prevalent in the depressive symptoms group (p <0.05). Age, abnormal blood glucose status, hypertension, and cholesterol level were not significantly associated with depressive symptoms (p >0.05). The mean CCA-IMT of those with depressive symptoms

Discussion

This population-based longitudinal study showed that the presence of depressive symptoms at baseline was associated with larger CCA-IMTs in subjects aged ≥65 years. Additionally, these data showed that when participants with abnormal CCA-IMTs at baseline were excluded, those participants remaining with depressive symptoms at baseline were 30% more likely to develop abnormal CCA-IMTs at follow-up than those without depressive symptoms at baseline (data not shown) and that in the full sample,

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    • Cited by (0)

    The Cardiovascular Health Study is conducted and supported by the National Heart, Lung, and Blood Institute, Bethesda, Maryland, in collaboration with the Cardiovascular Health Study investigators.

    †

    This report was prepared using a limited-access data set obtained by the National Heart, Lung, and Blood Institute and does not necessarily reflect the opinions or views of the Cardiovascular Health Study or the National Heart, Lung, and Blood Institute.

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    Copyright © 2007 Elsevier Inc. All rights reserved.