Baseline Depressive Symptoms Predict Subsequent Heart Disease; A 20-Year Cohort

Background: Depression is common among patients with heart disease. Depression is also associated with worse outcomes among patients with heart disease. Fewer studies have shown whether or not baseline depressive symptoms predict subsequent heart disease in general population.

Objectives: This study aimed to investigate whether depressive symptoms at baseline predict risk of developing heart disease during the next 20 years in the United States.

Patients and Methods: The data were extracted from the Health and Retirement Study (HRS), 1992 - 2012. The study was conducted on 8,375 individuals who were older than 50 years at entry, did not have heart disease at baseline, and had data on heart disease over the next 20 years. High depressive symptoms (modified Center for Epidemiologic Studies Depression Scale [CES-D]) were considered as the independent variable. Self-reported data on physician diagnosis of heart disease were measured on a biannual basis. Baseline demographic data (i.e., age and gender), socioeconomic status (i.e., race, marital status, and education level), health behaviors (i.e., drinking, smoking, and exercise), and body mass index were controlled. Cox proportional hazard model was used for data analysis.

Results: Cox proportional hazard model revealed a link between high depressive symptoms at baseline and time to developing heart disease (Hazard ratio = 1.439, 95% CI = 1.253 - 1.652), suggesting that individuals with high depressive symptoms at baseline developed heart disease sooner than others. The association between baseline depressive symptoms and risk of heart disease was significant after controlling for all the covariates.

Conclusions: Individuals with depressive symptomatology are at higher risk of development of heart disease over time. Thus, individuals with depressed mood may need more rigorous evaluation for heart disease.