Vascular disease risk factors as determinants of incident depressive symptoms: a prospective community-based study

BACKGROUND: The potential association between vascular disease and depression have been the focus for much clinical psychiatric research, although few epidemiological prospective studies have looked into this association. AIMS: This study explores the a priori hypothesis of a prospective association between cardiovascular disease or its risk factors and incident depressive symptoms. METHOD: A prospective primary care based study derived from a multi-centre randomized controlled trial of moderate hypertension. 2584 moderately-hypertensive volunteers were followed-up for 54 months when five assessments of depressive symptoms, vascular disease and its risk factors were made. RESULTS: We found an association between the dependent variable (incident depressive symptoms measured with the Self-CARE-D) and baseline smoker status, low serum cholesterol levels, poorer cognitive function (particularly executive dysfunction), female gender and increasing age. These associations were independent of all other cardiovascular risk factors (ECG evidence of ischaemia or arrhythmia, systolic or diastolic blood pressure, blood pressure decline along the trial and body mass index). CONCLUSIONS: Our results do not support the hypothesis of a specific association between vascular disease or its risk factors and incident depressive symptoms.