Associations between symptoms of depression and anxiety with left ventricular hypertrophy among Hispanic/Latino participants of the Hispanic Community Health Study/Study of Latinos

Background: Left ventricular hypertrophy (LVH) is a major independent risk factor for cardiovascular disease and is the leading cause of death among all U.S. groups, including Hispanic/Latino adults. LVH is commonly seen in the setting of hypertension and there is evidence that psychological factors, such as depression and anxiety, are risk factors in hypertension development. Objective: To evaluate the association between symptoms of depression and trait anxiety with incident LVH among U.S. Hispanic/Latino adults. Methods: The Hispanic Community Health Study/Study of Latinos is an ongoing population-based observational cohort study of Hispanic/Latino adults. Participants were examined in 2008-2011 at visit 1 (V1) and in 2014-2017 visit 2 (V2). Symptoms of depression and trait anxiety were assessed by self-reported questionnaire collection. LVH was assessed by echocardiography at V2. Multivariable Poisson regression models were used to determine the associations between symptoms of depression and trait anxiety at V1 with incident LVH at V2 among 6,612 participants after adjustment for potential confounders. All analyses accounted for the complex survey design and incorporated study weights. Results: After an average follow-up of 6.0 years, the age-standardized cumulative incidence of LVH was 5.4% (95% CI: 4.9, 6.1). The cumulative incidence of LVH was higher among participants with (10.4%, 95% CI: 8.6, 12.4) compared to without elevated symptoms of depression (5.1%; 95% CI: 4.4, 5.9). Compared with the lowest trait anxiety tertile (5.2%; 95% CI: 4.3, 6.3), the cumulative incidence of LVH was higher in the highest trait anxiety tertile (9.6%; 95% CI: 8.1, 11.5). In multivariable Poisson models, each standard deviation increment in symptoms of depression was associated with a 10% greater liklihood (IDR:1.10, 95% CI: 1.00, 1.20) of LVH at V2. However, symptoms of trait anxiety at visit 1 were not independently associated with LVH at visit 2. Conclusion: Greater depressive but not trait anxiety symptomatology was associated with LVH over six years. In fully adjusted models, a one-unit increase in depression symptomatology was associated with a 10% greater likelihood of LVH. Further studies are needed to examine the etiological role of negative affective psychological regulation.