Itamar S Santos1, Alessandra C Goulart2, André R Brunoni2, Andrew H Kemp3, Paulo A Lotufo4, Isabela M Bensenor4. 1. Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, Cerqueira César, São Paulo, Brazil. Electronic address: itamarss@usp.br. 2. Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil. 3. Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; School of Psychology and Discipline of Psychiatry, University of Sydney, Griffith Taylor Building (A19), Sydney, NSW 2006, Australia. 4. Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, Cerqueira César, São Paulo, Brazil.
Abstract
BACKGROUND: Studies focusing on the association between anxiety/depressive symptoms and accelerated subclinical atherosclerosis have yielded mixed results. Our aim is to examine associations between anxiety/depressive symptoms, common mental disorder (CMD), major depression disorder (MDD) or generalized anxiety disorder (GAD) and carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline. METHODS: The ELSA-Brasil baseline assessment included CIMT measurements and the Clinical Interview Schedule - Revised (CIS-R), a validated questionnaire for anxiety/depressive symptoms/diagnoses. We analyzed participants without previous coronary heart disease or stroke, and with high-quality CIMT images. We built regression models to determine whether the CIS-R score, CMD, MDD or GAD were associated with maximal CIMT levels. RESULTS: The study sample comprised 9744 participants. We found that individuals with higher CIS-R scores (Odds ratio for one standard deviation increase [OR]:1.12; 95% confidence interval [95%CI]:1.06-1.19), CMD (OR:1.22; 95%CI:1.07-1.38) and GAD (OR:1.19; 95%CI:1.01-1.41) had significantly higher odds of being classified in the highest age, sex and race-specific CIMT quartile. In the linear models, after adjustment for traditional cardiovascular risk factors, higher CIS-R scores (β:0.005; P = 0.010) and GAD (β:0.010; P = 0.049) were independently associated with CIMT values. CONCLUSION: Individuals with more symptoms of anxiety and/or depression, or diagnoses of CMD or GAD, had higher CIMT values, compared to peers of same age, sex and race. CIS-R scores and GAD were independently associated with higher CIMT values. These results suggest an association between anxiety/depressive symptoms (and, most notably, GAD) and accelerated subclinical atherosclerosis.
BACKGROUND: Studies focusing on the association between anxiety/depressive symptoms and accelerated subclinical atherosclerosis have yielded mixed results. Our aim is to examine associations between anxiety/depressive symptoms, common mental disorder (CMD), major depression disorder (MDD) or generalized anxiety disorder (GAD) and carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline. METHODS: The ELSA-Brasil baseline assessment included CIMT measurements and the Clinical Interview Schedule - Revised (CIS-R), a validated questionnaire for anxiety/depressive symptoms/diagnoses. We analyzed participants without previous coronary heart disease or stroke, and with high-quality CIMT images. We built regression models to determine whether the CIS-R score, CMD, MDD or GAD were associated with maximal CIMT levels. RESULTS: The study sample comprised 9744 participants. We found that individuals with higher CIS-R scores (Odds ratio for one standard deviation increase [OR]:1.12; 95% confidence interval [95%CI]:1.06-1.19), CMD (OR:1.22; 95%CI:1.07-1.38) and GAD (OR:1.19; 95%CI:1.01-1.41) had significantly higher odds of being classified in the highest age, sex and race-specific CIMT quartile. In the linear models, after adjustment for traditional cardiovascular risk factors, higher CIS-R scores (β:0.005; P = 0.010) and GAD (β:0.010; P = 0.049) were independently associated with CIMT values. CONCLUSION: Individuals with more symptoms of anxiety and/or depression, or diagnoses of CMD or GAD, had higher CIMT values, compared to peers of same age, sex and race. CIS-R scores and GAD were independently associated with higher CIMT values. These results suggest an association between anxiety/depressive symptoms (and, most notably, GAD) and accelerated subclinical atherosclerosis.
Authors: Aline Silva-Costa; Joanna Guimarães; Dora Chor; Maria de Jesus Mendes da Fonseca; Isabela Bensenor; Itamar Santos; Sandhi Barreto; Rosane Härter Griep Journal: Int Arch Occup Environ Health Date: 2018-04-02 Impact factor: 3.015
Authors: Elizabeth A Ellins; Martin J Shipley; D Aled Rees; Andrew Kemp; John E Deanfield; Eric J Brunner; Julian P Halcox Journal: Eur J Prev Cardiol Date: 2019-09-17 Impact factor: 7.804