Sven Speerforck1, F Dodoo-Schittko2, S Brandstetter2, C Apfelbacher2, U Hapke3, F Jacobi4,5, H J Grabe6, S E Baumeister7,8, G Schomerus6. 1. Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany. sven.speerforck@uni-greifswald.de. 2. Medical Sociology, Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany. 3. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany. 4. Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany. 5. Psychologische Hochschule Berlin, Berlin, Germany. 6. Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany. 7. Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany. 8. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Abstract
BACKGROUND: Major depressive disorder (MDD) and bipolar disorder are associated with certain cardiovascular risk factors (CVRFs), but it is unclear whether they are associated with unfavourable changes of clinically manifest CVRFs over time. METHODS: We used baseline and 12-year follow-up (n = 1887) data from the German Health Interview and Examination Survey 1998. Multivariable linear regression models assessed associations between lifetime CIDI-diagnosed mood disorders at baseline and continuous risk factor-related outcomes (blood pressure, HbA1c, LDL-C, HDL-C, triglycerides, BMI) at follow-up. RESULTS: We did not find consistent deterioration of CVRFs in persons with compared to persons without MDD. Analyses pointed to severity of mood disorder as an important correlate of long-term changes of comorbid hypertension: while a history of mild MDD was not associated with changes in CVRFs, moderate MDD was associated with lower blood pressure [systolic: β = - 7.5 (CI - 13.2; - 1.9); diastolic: β = - 4.5 (CI - 7.8; - 1.3)] and a history of bipolar disorder was associated with higher systolic blood pressure at follow-up (β = 14.6; CI 4.9-24.4). Further, severe MDD was weakly associated with a higher BMI at follow-up [β = 1.2 (CI 0.0; 2.4)]. These outcomes were not mediated by use of psychotropic medication and remained statistically significant after adjusting for the use of antihypertensive medication. CONCLUSION: Since most investigated parameters showed no associations, participants with a lifetime history of MDD in this cohort did not carry a specific risk for a worsening of pre-existing clinically manifest CVRFs. Our findings extend evidence of MDD severity and bipolar disorder as important correlates of long-term changes of arterial hypertension and obesity.
BACKGROUND: Major depressive disorder (MDD) and bipolar disorder are associated with certain cardiovascular risk factors (CVRFs), but it is unclear whether they are associated with unfavourable changes of clinically manifest CVRFs over time. METHODS: We used baseline and 12-year follow-up (n = 1887) data from the German Health Interview and Examination Survey 1998. Multivariable linear regression models assessed associations between lifetime CIDI-diagnosed mood disorders at baseline and continuous risk factor-related outcomes (blood pressure, HbA1c, LDL-C, HDL-C, triglycerides, BMI) at follow-up. RESULTS: We did not find consistent deterioration of CVRFs in persons with compared to persons without MDD. Analyses pointed to severity of mood disorder as an important correlate of long-term changes of comorbid hypertension: while a history of mild MDD was not associated with changes in CVRFs, moderate MDD was associated with lower blood pressure [systolic: β = - 7.5 (CI - 13.2; - 1.9); diastolic: β = - 4.5 (CI - 7.8; - 1.3)] and a history of bipolar disorder was associated with higher systolic blood pressure at follow-up (β = 14.6; CI 4.9-24.4). Further, severe MDD was weakly associated with a higher BMI at follow-up [β = 1.2 (CI 0.0; 2.4)]. These outcomes were not mediated by use of psychotropic medication and remained statistically significant after adjusting for the use of antihypertensive medication. CONCLUSION: Since most investigated parameters showed no associations, participants with a lifetime history of MDD in this cohort did not carry a specific risk for a worsening of pre-existing clinically manifest CVRFs. Our findings extend evidence of MDD severity and bipolar disorder as important correlates of long-term changes of arterial hypertension and obesity.
Authors: Magdalena Beran; Rutendo Muzambi; Anouk Geraets; Juan Rafael Albertorio-Diaz; Marcel C Adriaanse; Marjolein M Iversen; Andrzej Kokoszka; Giesje Nefs; Arie Nouwen; Frans Pouwer; Jörg W Huber; Andreas Schmitt; Miranda T Schram Journal: Diabet Med Date: 2021-09-05 Impact factor: 4.213