Debra D Dixon1, Meng Xu2, Elvis A Akwo3, Devika Nair4, David Schlundt5, Thomas J Wang6, William J Blot7, Loren Lipworth8, Deepak K Gupta9. 1. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 2. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 3. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 4. Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA. 5. Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA. 6. Department of Medicine, UT-Southwestern Medical Center, Dallas, Texas, USA. 7. Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 8. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA; Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 9. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: d.gupta@vumc.org.
Abstract
OBJECTIVES: This study aims to examine whether greater frequency of depressive symptoms associates with increased risk of incident heart failure (HF). BACKGROUND: Depressive symptoms associate with adverse prognosis in patients with prevalent HF. Their association with incident HF is less studied, particularly in low-income and minority individuals. METHODS: We studied 23,937 Black or White Southern Community Cohort Study participants (median age: 53 years, 70% Black, 64% women) enrolled between 2002 and 2009, without prevalent HF, receiving Centers for Medicare and Medicaid Services coverage. Cox models adjusted for traditional HF risk factors, socioeconomic and behavioral factors, social support, and antidepressant medications were used to quantify the association between depressive symptoms assessed at enrollment via the Center for Epidemiologic Studies Depression Scale (CESD-10) and incident HF ascertained from Centers for Medicare and Medicaid Services International Classification of Diseases-9th Revision (ICD-9) (code: 428.x) and ICD-10 (codes: I50, I110) codes through December 31, 2016. RESULTS: The median CESD-10 score was 9 (IQR: 5 to 13). Over a median 11-year follow-up, 6,081 (25%) participants developed HF. The strongest correlates of CESD-10 score were antidepressant medication use, age, and socioeconomic factors, rather than traditional HF risk factors. Greater frequency of depressive symptoms associated with increased incident HF risk (per 8-U higher CESD-10 HR: 1.04; 95% CI: 1.00 to 1.09; P = 0.038) without variation by race or sex. The association between depressive symptoms and incident HF varied by antidepressant use (interaction-P = 0.03) with increased risk among individuals not taking antidepressants. CONCLUSIONS: In this high-risk, low-income, cohort of predominantly Black participants, greater frequency of depressive symptoms significantly associates with higher risk of incident HF.
OBJECTIVES: This study aims to examine whether greater frequency of depressive symptoms associates with increased risk of incident heart failure (HF). BACKGROUND: Depressive symptoms associate with adverse prognosis in patients with prevalent HF. Their association with incident HF is less studied, particularly in low-income and minority individuals. METHODS: We studied 23,937 Black or White Southern Community Cohort Study participants (median age: 53 years, 70% Black, 64% women) enrolled between 2002 and 2009, without prevalent HF, receiving Centers for Medicare and Medicaid Services coverage. Cox models adjusted for traditional HF risk factors, socioeconomic and behavioral factors, social support, and antidepressant medications were used to quantify the association between depressive symptoms assessed at enrollment via the Center for Epidemiologic Studies Depression Scale (CESD-10) and incident HF ascertained from Centers for Medicare and Medicaid Services International Classification of Diseases-9th Revision (ICD-9) (code: 428.x) and ICD-10 (codes: I50, I110) codes through December 31, 2016. RESULTS: The median CESD-10 score was 9 (IQR: 5 to 13). Over a median 11-year follow-up, 6,081 (25%) participants developed HF. The strongest correlates of CESD-10 score were antidepressant medication use, age, and socioeconomic factors, rather than traditional HF risk factors. Greater frequency of depressive symptoms associated with increased incident HF risk (per 8-U higher CESD-10 HR: 1.04; 95% CI: 1.00 to 1.09; P = 0.038) without variation by race or sex. The association between depressive symptoms and incident HF varied by antidepressant use (interaction-P = 0.03) with increased risk among individuals not taking antidepressants. CONCLUSIONS: In this high-risk, low-income, cohort of predominantly Black participants, greater frequency of depressive symptoms significantly associates with higher risk of incident HF.
Authors: Judith H Lichtman; Erika S Froelicher; James A Blumenthal; Robert M Carney; Lynn V Doering; Nancy Frasure-Smith; Kenneth E Freedland; Allan S Jaffe; Erica C Leifheit-Limson; David S Sheps; Viola Vaccarino; Lawson Wulsin Journal: Circulation Date: 2014-02-24 Impact factor: 29.690
Authors: Adrienne O'Neil; Aaron J Fisher; Katherine J Kibbey; Felice N Jacka; Mark A Kotowicz; Lana J Williams; Amanda L Stuart; Michael Berk; Paul A Lewandowski; Craig B Taylor; Julie A Pasco Journal: J Affect Disord Date: 2016-02-16 Impact factor: 4.839
Authors: Danielle M Kubicki; Meng Xu; Elvis A Akwo; Debra Dixon; Daniel Muñoz; William J Blot; Thomas J Wang; Loren Lipworth; Deepak K Gupta Journal: JACC Heart Fail Date: 2019-11-11 Impact factor: 12.035
Authors: Krista C van den Broek; Christopher R Defilippi; Robert H Christenson; Stephen L Seliger; John S Gottdiener; Willem J Kop Journal: Am J Cardiol Date: 2011-03-01 Impact factor: 2.778
Authors: Eric L Harshfield; Lisa Pennells; Joseph E Schwartz; Peter Willeit; Stephen Kaptoge; Steven Bell; Jonathan A Shaffer; Thomas Bolton; Sarah Spackman; Sylvia Wassertheil-Smoller; Frank Kee; Philippe Amouyel; Steven J Shea; Lewis H Kuller; Jussi Kauhanen; E M van Zutphen; Dan G Blazer; Harlan Krumholz; Paul J Nietert; Daan Kromhout; Gail Laughlin; Lisa Berkman; Robert B Wallace; Leon A Simons; Elaine M Dennison; Elizabeth L M Barr; Haakon E Meyer; Angela M Wood; John Danesh; Emanuele Di Angelantonio; Karina W Davidson Journal: JAMA Date: 2020-12-15 Impact factor: 56.272