Key result
Sustained depressive symptoms in women linked to ~88% higher odds of LVH over 20 years.
Why the study?
Depression is a risk factor for coronary heart disease and LVH is a potent predictor of coronary heart disease events, but whether depression is associated with LVH has received limited investigation.
Does a 20-year longitudinal trajectory of depressive symptoms increase the risk of adverse left ventricular geometry outcomes in adults?
Cohort (n=2,533)
Yes
Does a 20-year longitudinal trajectory of depressive symptoms increase the risk of adverse left ventricular geometry outcomes in adults?
Odds Ratio: 1.88 (95% CI 1.16–3.04)
Long-term depressive symptom trajectories are independently associated with an increased risk of left ventricular hypertrophy in females but not males, highlighting a sex-specific pathophysiological link potentially mediated by sex hormones.
OBJECTIVE: Depression is a risk factor for coronary heart disease and left ventricular hypertrophy (LVH) is a potent predictor of coronary heart disease events. Whether depression is associated with LVH has received limited investigation. This study assessed cross-sectional and 20-year longitudinal associations of depressive symptoms with LVH outcomes after accounting for important known confounders. METHODS: From 5115 participants enrolled in 1985-1986 in the Coronary Artery Risk Development in Young Adults Study, 2533 had serial measures of depressive symptoms and subsequent echocardiography to measure normal LV geometry, concentric remodeling, and LVH. The primary exposure variable was trajectories of the Center for Epidemiologic Studies Depression (CES-D) scale score from 1990-1991 to 2010-2011. Multivariable polytomous logistic regression was used to assess associations of trajectories with a composite LV geometry outcome created using echocardiogram data measured in 2010-2011 and 2015-2016. Sex-specific conflicting results led to exploratory models that examined potential importance of testosterone and sex hormone-binding globulin. RESULTS: Overall CES-D and Somatic subscale trajectories had significant associations with LVH for female participants only. Odds ratios for the subthreshold (mean CES-D ≈ 14) and stable (mean CES-D ≈ 19) groups were 1.49 (95% confidence interval = 1.05-2.13) and 1.88 (95% confidence interval = 1.16-3.04), respectively. For female participants, sex hormone-binding globulin was inversely associated with LVH, and for male participants, bioavailable testosterone was positively associated with concentric geometry. CONCLUSIONS: Findings from cross-sectional and longitudinal regression models for female participants, but not male ones, and particularly for Somatic subscale trajectories suggested a plausible link among depression, androgens, and LVH. The role of androgens to the depression-LVH relation requires additional investigation in future studies.
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Colangelo et al. (2024) conducted a cohort in Healthy young adults at baseline (n=2,533). Trajectories of depressive symptoms (CES-D scale) vs. No depression trajectory was evaluated on Left ventricular hypertrophy (LVH) (OR 1.88, 95% CI 1.16-3.04). In female participants, stable trajectories of elevated depressive symptoms over 20 years were significantly associated with left ventricular hypertrophy (OR 1.88) compared to the no depression group.
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