OBJECTIVES: Gender disparities, particularly among young women with cardiovascular disease, are a growing cause for concern. Depression is a prevalent and prognostically important comorbidity in peripheral arterial disease (PAD), but its prevalence has not been described as a function of gender and age. Therefore, we compared depressive symptoms at the time of PAD diagnosis and 6 months later by gender and age in PAD patients. METHODS: The study enrolled 444 newly diagnosed patients with PAD (32% women) from two Dutch vascular outpatient clinics. Patients' depressive symptoms were assessed with the 10-item Center for Epidemiological Studies Depression Scale (CES-D) at baseline and 6 months later (CES-D scores >or=4 indicate significant depressive symptoms). Logistic regression models were constructed to evaluate the relationship among four gender-age groups (women <65 and >or=65 years; men <65 and >or=65 years [reference category]) and baseline and 6-month follow-up depressive symptoms. RESULTS: Initially, 33% of women <65 years had significant depressive symptoms, and 6 months later, significant depressive symptoms had developed in 19% of the other younger women. These rates were much higher than other gender-age groups (range at baseline, 11%-16%; 6-month incidence, 6%-10%; P <or= .03). Adjusting for demographics and clinical factors, women <65 years experienced a fourfold greater odds of baseline (odds ratio [OR], 4.3; 95% confidence interval [CI], 2.2-8.7) and follow-up depressive symptoms (OR, 4.1; 95% CI, 2.0-8.4) compared with men >or=65 years, whereas other gender-age groups were not at risk. Additional adjustment for change in the ankle-brachial index did not explain the increased depression risk in younger women (OR, 3.5; 95% CI, 1.2-10.2). CONCLUSIONS: Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups, both at the time of diagnosis and 6 months later. To eradicate gender-based disparities in PAD, depression screening and monitoring in younger women may be an important direction for future research and intervention.
OBJECTIVES: Gender disparities, particularly among young women with cardiovascular disease, are a growing cause for concern. Depression is a prevalent and prognostically important comorbidity in peripheral arterial disease (PAD), but its prevalence has not been described as a function of gender and age. Therefore, we compared depressive symptoms at the time of PAD diagnosis and 6 months later by gender and age in PAD patients. METHODS: The study enrolled 444 newly diagnosed patients with PAD (32% women) from two Dutch vascular outpatient clinics. Patients' depressive symptoms were assessed with the 10-item Center for Epidemiological Studies Depression Scale (CES-D) at baseline and 6 months later (CES-D scores >or=4 indicate significant depressive symptoms). Logistic regression models were constructed to evaluate the relationship among four gender-age groups (women <65 and >or=65 years; men <65 and >or=65 years [reference category]) and baseline and 6-month follow-up depressive symptoms. RESULTS: Initially, 33% of women <65 years had significant depressive symptoms, and 6 months later, significant depressive symptoms had developed in 19% of the other younger women. These rates were much higher than other gender-age groups (range at baseline, 11%-16%; 6-month incidence, 6%-10%; P <or= .03). Adjusting for demographics and clinical factors, women <65 years experienced a fourfold greater odds of baseline (odds ratio [OR], 4.3; 95% confidence interval [CI], 2.2-8.7) and follow-up depressive symptoms (OR, 4.1; 95% CI, 2.0-8.4) compared with men >or=65 years, whereas other gender-age groups were not at risk. Additional adjustment for change in the ankle-brachial index did not explain the increased depression risk in younger women (OR, 3.5; 95% CI, 1.2-10.2). CONCLUSIONS: Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups, both at the time of diagnosis and 6 months later. To eradicate gender-based disparities in PAD, depression screening and monitoring in younger women may be an important direction for future research and intervention.
Authors: Grace J Wang; Pamela A Shaw; Raymond R Townsend; Amanda H Anderson; Dawei Xie; Xue Wang; Lisa C Nessel; Emile R Mohler; Stephen M Sozio; Bernard G Jaar; Jing Chen; Jackson Wright; Jonathan J Taliercio; Akinlolu Ojo; Ana C Ricardo; Eva Lustigova; Ronald M Fairman; Harold I Feldman; Bonnie Ky Journal: Circ Cardiovasc Qual Outcomes Date: 2016-02
Authors: S Marlene Grenon; Beth E Cohen; Kim Smolderen; Eric Vittinghoff; Mary A Whooley; Jade Hiramoto Journal: J Vasc Surg Date: 2014-03-22 Impact factor: 4.268
Authors: Rachel P Dreyer; Moniek van Zitteren; John F Beltrame; Robert Fitridge; Johan Denollet; Patrick W Vriens; John A Spertus; Kim G Smolderen Journal: J Am Heart Assoc Date: 2014-12-23 Impact factor: 5.501
Authors: Qurat-Ul-Ain Jelani; Carlos Mena-Hurtado; Matthew Burg; Robert Soufer; Kensey Gosch; Philip G Jones; John A Spertus; Basmah Safdar; Kim G Smolderen Journal: J Am Heart Assoc Date: 2020-08-12 Impact factor: 5.501