Relation of Persistent Depressive Symptoms to Coronary Artery Calcification in Women Aged 46 to 59 Years

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• 作者：Imke Janssen ; PhD^a ; ^{Imke_Janssen@rush.edu" class="auth_mail" title="E-mail the corresponding author} ; Lynda H. Powell ; PhD^b ; Karen A. Matthews ; PhD^c ; Mateusz S. Jasielec ; MS^a ; Steven M. Hollenberg ; MD^d ; Joyce T. Bromberger ; PhD^e ; Kim Sutton-Tyrrell ; DrPH^f ; ^&dagger ; ; Susan A. Everson-Rose ; PhD^g
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：15 June 2016
• 年：2016
• 卷：117
• 期：12
• 页码：1884-1889
• 全文大小：207 K

文摘

Depressive disorders have been associated with cardiovascular disease (CVD), but the impact of depression on early atherogenesis has not been well described, particularly in women and minorities. The relation between repeated episodes of high depressive symptoms and coronary calcium (CAC) is unknown in women at midlife when depression is common. Participants in the Study of Women's Health Across the Nation Heart study were assessed annually for depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D scale]) over 5 years before CAC assessment and classified as high (CES-D ≥16) or not. CAC, measured by computed tomography, was analyzed as a categorical variable using cumulative logit partial proportional odds models. In these middle-aged women free of CVD and diabetes (194 black, 334 white), high depressive symptoms over 5 years were common; 19% had 1, 9% had 2, and 11% experienced ≥3 episodes. CAC was low; 54% had no CAC, 25% had scores from 0 to 10, and 21% had CAC ≥10 Agatston score. After adjusting for CVD risk factors, women with ≥3 episodes were twice as likely to have significant CAC (≥10 Agatston units) than women with no depressive episodes (odds ratio 2.20, 95% confidence interval 1.13 to 4.28, p = 0.020) with no difference by race. Women with 1 or 2 episodes did not differ from women with no episodes. In conclusion, in healthy women aged 46 to 59 years without clinical CVD or diabetes, persistent depressive symptoms were significantly associated with elevated CAC scores, suggesting that they are more likely to have pathophysiological and behavioral effects on the development of subclinical CVD than does a single episode of elevated depressive symptoms.