Claudia Szlejf1, Claudia K Suemoto2, Itamar S Santos3, Andre R Brunoni4, Maria Angélica Nunes5, Maria Carmen Viana6, Sandhi Maria Barreto7, Paulo A Lotufo3, Isabela M Benseñor3. 1. Center for Clinical and Epidemiological Research, Hospital Universitario, Univeristy of Sao Paulo, Sao Paulo, Brazil. Electronic address: claujeru@gmail.com. 2. Center for Clinical and Epidemiological Research, Hospital Universitario, Univeristy of Sao Paulo, Sao Paulo, Brazil; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil. 3. Center for Clinical and Epidemiological Research, Hospital Universitario, Univeristy of Sao Paulo, Sao Paulo, Brazil; Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil. 4. Service of Interdisciplinary Neuromodulation, Laboratory of Neuroscience and National Institute of Biomarkers in Psychiatry, Department and Institute of Psychiatry, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. 5. Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil. 6. Center of Psychiatric Epidemiology (CEPEP), Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil. 7. Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Abstract
BACKGROUND: Common psychiatric symptoms may hinder achieving ideal cardiovascular health (ICH). We aimed to investigate the association between the ICH score and psychiatric disorders in Brazilian adults. METHODS: In this cross-sectional analysis, 13,743 participants free of cardiovascular disease from the ELSA-Brasil study were assessed using the American Heart Association ICH score. Cardiovascular health was classified as poor (0-2 ideal metrics), intermediate (3-4 ideal metrics), and optimal (5-7 ideal metrics). We used the Clinical Interview Scheduled Revised (CIS-R) to assess psychiatric disorders and investigate their association with the ICH score and each non-ICH metric. RESULTS: The frequency of poor, intermediate, and optimal cardiovascular health were 54.1%, 38.1%, and 7.8%, respectively. Depressive and anxiety disorders were associated with poor cardiovascular health (depressive disorder: OR = 2.49, 95% CI = 1.62-3.80, p < 0.001; anxiety disorder: OR = 1.47, 95% CI = 1.22-1.78, p < 0.001), and intermediate cardiovascular health (depressive disorder: OR = 1.94, 95% CI = 1.26-2.98, p = 0.002; anxiety disorder: OR = 1.22, 95% CI = 1.01-1.47, p = 0.043). In the analysis stratified by sex, these associations were significant only among women. The disorders were also associated with the following non-ICH metrics: body mass index, physical activity, healthy diet score, and smoking. Participants with depressive disorder and anxiety disorder had expected lower global and lifestyle ICH score than participants without these conditions, with significant results among women in the stratified analysis. CONCLUSION: Psychiatric comorbidity was associated with poorer cardiovascular health. These conditions may compromise the adoption of healthy cardiovascular risk reduction behaviors.
BACKGROUND: Common psychiatric symptoms may hinder achieving ideal cardiovascular health (ICH). We aimed to investigate the association between the ICH score and psychiatric disorders in Brazilian adults. METHODS: In this cross-sectional analysis, 13,743 participants free of cardiovascular disease from the ELSA-Brasil study were assessed using the American Heart Association ICH score. Cardiovascular health was classified as poor (0-2 ideal metrics), intermediate (3-4 ideal metrics), and optimal (5-7 ideal metrics). We used the Clinical Interview Scheduled Revised (CIS-R) to assess psychiatric disorders and investigate their association with the ICH score and each non-ICH metric. RESULTS: The frequency of poor, intermediate, and optimal cardiovascular health were 54.1%, 38.1%, and 7.8%, respectively. Depressive and anxiety disorders were associated with poor cardiovascular health (depressive disorder: OR = 2.49, 95% CI = 1.62-3.80, p < 0.001; anxiety disorder: OR = 1.47, 95% CI = 1.22-1.78, p < 0.001), and intermediate cardiovascular health (depressive disorder: OR = 1.94, 95% CI = 1.26-2.98, p = 0.002; anxiety disorder: OR = 1.22, 95% CI = 1.01-1.47, p = 0.043). In the analysis stratified by sex, these associations were significant only among women. The disorders were also associated with the following non-ICH metrics: body mass index, physical activity, healthy diet score, and smoking. Participants with depressive disorder and anxiety disorder had expected lower global and lifestyle ICH score than participants without these conditions, with significant results among women in the stratified analysis. CONCLUSION:Psychiatric comorbidity was associated with poorer cardiovascular health. These conditions may compromise the adoption of healthy cardiovascular risk reduction behaviors.
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Authors: Julia Berkowitz; Vishal Khetpal; Justin B Echouffo-Tcheugui; Claudia E Bambs; Aryan Aiyer; Kevin E Kip; Steven E Reis; Sebhat Erqou Journal: Am J Prev Cardiol Date: 2022-07-17