Association of Symptoms of Depression With Cardiovascular Disease and Mortality in Low-, Middle-, and High-Income Countries
Key result
Four or more depressive symptoms were associated with an increased risk of incident cardiovascular disease (HR 1.14; 95% CI 1.05-1.24) and all-cause mortality (HR 1.17; 95% CI 1.11-1.25).
Why the study?
Depression is linked to CVD and premature death in high-income countries, but whether this holds in low- and middle-income countries and urban areas is unknown.
Does the presence of depressive symptoms increase the risk of incident cardiovascular disease and mortality in adults across economically diverse countries?
Population
145 862 participants aged 35 to 70 years across 21 countries
Comparison
Four or more self-reported depressive symptoms vs fewer
Design
Multicenter population-based cohort study
Follow-up
Median, 9.3 years
Authors
Discussion
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Member takes
Implication
May warrant depression screening in CVD risk assessment; leaves open causality and treatment effects on events.
Study Design
Type
Cohort (n=145,862)
Multicenter
Yes
Structured PICO
Does the presence of depressive symptoms increase the risk of incident cardiovascular disease and mortality in adults across economically diverse countries?
P
Population
145,862 adults aged 35 to 70 years from 21 economically diverse countries, followed for a median of 9.3 years.
E
Exposure
Presence of 4 or more self-reported depressive symptoms (assessed via the Short-Form Composite International Diagnostic Interview)
C
Comparator
Fewer than 4 depressive symptoms
O
Outcome
Incident CVD, all-cause mortality, and a combined measure of either incident CVD or all-cause mortalityhard clinical
Main Result
Hazard Ratio: 1.14 (95% CI 1.05–1.24)
Self-reported depressive symptoms are independently associated with a higher risk of incident cardiovascular disease and all-cause mortality globally, with stronger effects observed in urban areas and in men.
Cite This Study
Rajan et al. (2020) conducted a cohort in Depression (n=145,862). Four or more self-reported depressive symptoms vs. Fewer than 4 depressive symptoms was evaluated on Incident CVD (HR 1.14, 95% CI 1.05-1.24). Four or more depressive symptoms were associated with an increased risk of incident cardiovascular disease (HR 1.14; 95% CI 1.05-1.24) and all-cause mortality (HR 1.17; 95% CI 1.11-1.25).