Depression, anxiety and 6-year risk of cardiovascular disease

• Published in: Journal of psychosomatic research 2015-02, Vol.78 (2), p.123-129
• Main Authors: Seldenrijk, Adrie, Vogelzangs, Nicole, Batelaan, Neeltje M, Wieman, Iris, van Schaik, Digna J.F, Penninx, Brenda J.W.H
• Format: Article
• Language: English
• Subjects: Adult; Anxiety - complications; Anxiety disorders; Anxiety Disorders - complications; Anxiety Disorders - diagnosis; Anxiety Disorders - drug therapy; Benzodiazepines - administration & dosage; Benzodiazepines - adverse effects; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - psychology; Depression - complications; Depressive Disorder - complications; Depressive Disorder - diagnosis; Depressive Disorder - drug therapy; Depressive disorders; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Netherlands - epidemiology; Odds Ratio; Personality Inventory; Proportional Hazards Models; Psychiatry; Risk Assessment; Risk Factors; Self Report; Severity of Illness Index; Surveys and Questionnaires
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2014.10.007

Abstract Objective Depression and anxiety are considered etiological factors in cardiovascular disease (CVD), though their relative contribution and differentiation by clinical characteristics have not been studied intensively. We examined 6-year associations between depressive and anxiety disorders, clinical characteristics and newly-developed CVD. Methods DSM-IV diagnoses were established in 2510 CVD-free participants of the Netherlands Study of Depression and Anxiety. Data on subtype, severity, and psychoactive medication were collected. The 6-year incidence of CVD was assessed using Cox regression analyses adjusted for sociodemographic, health and lifestyle factors. Results One-hundred-six subjects (4.2%) developed CVD. Having both current depressive and anxiety disorders (HR = 2.86, 95%CI 1.49–5.49) or current depression only (HR = 2.30; 95%CI 1.10–4.80) was significantly associated with increased CVD incidence, whereas current anxiety only (HR = 1.48; 95%CI 0.74–2.96) and remitted disorders (HR = 1.48; 95%CI 0.80–2.75) were not associated. Symptom severity was associated with increased CVD onset (e.g., Inventory of Depressive Symptomatology per SD increase: HR = 1.51; 95%CI 1.25–1.83). Benzodiazepine use was associated with additional CVD risk (HR = 1.95; 95%CI 1.16–3.31). Conclusions Current depressive (but not anxiety) disorder independently contributed to CVD in our sample of initially CVD-free participants. CVD incidence over 6 years of follow-up was particularly increased in subjects with more symptoms, and in those using benzodiazepines.