OBJECTIVE: The aim of this study is to examine ethnic differences in depressive symptoms and antidepressant treatment in a cohort of patients undergoing diagnostic coronary angiography. BACKGROUND: Coronary heart disease (CHD) is the leading cause of mortality in the United States, with an excess of mortality in African Americans. Traditional risk factors occur more frequently among African Americans but do not fully account for this increased risk. Elevated depressive symptoms have been shown to be associated with higher morbidity and mortality in patients with CHD. METHODS: A consecutive series of 864 patients (727 whites, 137 African Americans) completed the Beck Depression Inventory to assess depressive symptoms. Data describing cardiovascular risk factors and type of medications including antidepressants were obtained from chart review at the time of study enrollment. RESULTS: There was no difference in the severity of depressive symptoms between whites (P = .50); the prevalence of elevated depressive symptoms also was similar for African Americans (35%) and whites (27%) (P = .20). However, the rate of antidepressant use was 21% for whites but only 11.7% for African Americans (P = .016). The odds ratio for ethnicity (African American vs whites) in predicting antidepressant use was 0.43 (95% confidence interval 0.24-0.76, P = .004) after adjustment for Beck Depression Inventory scores. CONCLUSIONS: African Americans with CHD are less likely to be treated with antidepressant medications compared with whites despite having similar levels of depression. The ethnic differences in the psychopharmacological management of depression suggests that more careful assessment of depression, especially in African Americans, is necessary to optimize care of patients with CHD.
OBJECTIVE: The aim of this study is to examine ethnic differences in depressive symptoms and antidepressant treatment in a cohort of patients undergoing diagnostic coronary angiography. BACKGROUND:Coronary heart disease (CHD) is the leading cause of mortality in the United States, with an excess of mortality in African Americans. Traditional risk factors occur more frequently among African Americans but do not fully account for this increased risk. Elevated depressive symptoms have been shown to be associated with higher morbidity and mortality in patients with CHD. METHODS: A consecutive series of 864 patients (727 whites, 137 African Americans) completed the Beck Depression Inventory to assess depressive symptoms. Data describing cardiovascular risk factors and type of medications including antidepressants were obtained from chart review at the time of study enrollment. RESULTS: There was no difference in the severity of depressive symptoms between whites (P = .50); the prevalence of elevated depressive symptoms also was similar for African Americans (35%) and whites (27%) (P = .20). However, the rate of antidepressant use was 21% for whites but only 11.7% for African Americans (P = .016). The odds ratio for ethnicity (African American vs whites) in predicting antidepressant use was 0.43 (95% confidence interval 0.24-0.76, P = .004) after adjustment for Beck Depression Inventory scores. CONCLUSIONS: African Americans with CHD are less likely to be treated with antidepressant medications compared with whites despite having similar levels of depression. The ethnic differences in the psychopharmacological management of depression suggests that more careful assessment of depression, especially in African Americans, is necessary to optimize care of patients with CHD.
Authors: Elliott M Antman; Daniel T Anbe; Paul Wayne Armstrong; Eric R Bates; Lee A Green; Mary Hand; Judith S Hochman; Harlan M Krumholz; Frederick G Kushner; Gervasio A Lamas; Charles J Mullany; Joseph P Ornato; David L Pearle; Michael A Sloan; Sidney C Smith Journal: J Am Coll Cardiol Date: 2004-08-04 Impact factor: 24.094
Authors: Bernice Ruo; John S Rumsfeld; Mark A Hlatky; Haiying Liu; Warren S Browner; Mary A Whooley Journal: JAMA Date: 2003-07-09 Impact factor: 56.272
Authors: James A Blumenthal; Heather S Lett; Michael A Babyak; William White; Peter K Smith; Daniel B Mark; Robert Jones; Joseph P Mathew; Mark F Newman Journal: Lancet Date: 2003-08-23 Impact factor: 79.321
Authors: Heather S Lett; James A Blumenthal; Michael A Babyak; Andrew Sherwood; Timothy Strauman; Clive Robins; Mark F Newman Journal: Psychosom Med Date: 2004 May-Jun Impact factor: 4.312
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Doreen Koretz; Kathleen R Merikangas; A John Rush; Ellen E Walters; Philip S Wang Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Florian Rader; Otto Costantini; Craig Jarrett; Eiran Z Gorodeski; Michael S Lauer; Eugene H Blackstone Journal: J Electrocardiol Date: 2011-01-26 Impact factor: 1.438
Authors: Robert J Mentz; Michael A Babyak; Vera Bittner; Jerome L Fleg; Steven J Keteyian; Ann M Swank; Ileana L Piña; William E Kraus; David J Whellan; Christopher M O'Connor; James A Blumenthal Journal: Circ Heart Fail Date: 2015-04-21 Impact factor: 8.790
Authors: Kenneth E Freedland; Brian C Steinmeyer; Robert M Carney; Judith A Skala; Michael W Rich Journal: Gen Hosp Psychiatry Date: 2020-04-25 Impact factor: 3.238
Authors: Manish K Jha; Arman Qamar; Muthiah Vaduganathan; Dennis S Charney; James W Murrough Journal: J Am Coll Cardiol Date: 2019-04-16 Impact factor: 24.094
Authors: Brett D Thombs; Ademola B Adeponle; Laurence J Kirmayer; Cécile Rousseau; Roy C Ziegelstein Journal: Am Heart J Date: 2009-05 Impact factor: 4.749