Stephanie A Hooker1, Patrick J O'Connor2, JoAnn M Sperl-Hillen3, A Lauren Crain4, Kris Ohnsorg5, Sheryl Kane6, Rebecca Rossom7. 1. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: stephanie.a.hooker@healthpartners.com. 2. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: Patrick.j.oconnor@healthpartners.com. 3. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: joann.m.sperlhillen@healthpartners.com. 4. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: lauren.a.crain@healthpartners.com. 5. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: kris.a.ohnsorg@healthpartners.com. 6. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: sheryl.m.kane@healthpartners.com. 7. HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN, United States of America. Electronic address: rebecca.c.rossom@healthpartners.com.
Abstract
OBJECTIVE: This study assessed the relationship of both depression diagnosis and clinically significant depressive symptoms with individual cardiovascular risk factors and estimated total cardiovascular risk in primary care patients. METHODS: This study used a cross-sectional and retrospective design. Patients who had a primary care encounter between January 2016 and September 2018 and completed depression screening (PHQ-9) during the year prior to their appointment (N = 70,980) were included in this study. Data examining estimated total cardiovascular risk, specific cardiovascular risk factors, and relevant clinical diagnoses (including depression diagnosis) were extracted from the electronic health record. Patients were categorized into three groups: no depression (PHQ-9 < 10 and no depression diagnosis), controlled depression (PHQ-9 < 10 with previous depression diagnosis), and current depression (PHQ-9 ≥ 10). Groups were compared on estimated total risk and specific cardiovascular risk factors (e.g., body mass index [BMI], smoking status, lipids, blood pressure, and glucose). RESULTS: In adjusted analyses, patients with current depression (n = 18,267) demonstrated significantly higher 10-year and 30-year cardiovascular risk compared to patients with controlled depression (n = 33,383; 10-year: b = 0.59 [95% CI = 0.44,0.74]; 30-year: OR = 1.32 [95% CI = 1.26,1.39]) and patients without depression (n = 19,330; 10-year: b = 0.55 [95% CI = 0.37,0.73]; 30-year: OR = 1.56 [95% CI = 1.48,1.65]). Except for low-density lipoprotein (LDL), patients with current depression had the greatest cardiovascular risk across specific risk factors. CONCLUSIONS: Individuals who had a depression diagnosis and clinically significant depressive symptoms had the greatest cardiovascular risk. Pathways to prevent cardiovascular disease in those with depression might focus on treating depressive symptoms as well as specific uncontrolled cardiovascular risk factors.
OBJECTIVE: This study assessed the relationship of both depression diagnosis and clinically significant depressive symptoms with individual cardiovascular risk factors and estimated total cardiovascular risk in primary care patients. METHODS: This study used a cross-sectional and retrospective design. Patients who had a primary care encounter between January 2016 and September 2018 and completed depression screening (PHQ-9) during the year prior to their appointment (N = 70,980) were included in this study. Data examining estimated total cardiovascular risk, specific cardiovascular risk factors, and relevant clinical diagnoses (including depression diagnosis) were extracted from the electronic health record. Patients were categorized into three groups: no depression (PHQ-9 < 10 and no depression diagnosis), controlled depression (PHQ-9 < 10 with previous depression diagnosis), and current depression (PHQ-9 ≥ 10). Groups were compared on estimated total risk and specific cardiovascular risk factors (e.g., body mass index [BMI], smoking status, lipids, blood pressure, and glucose). RESULTS: In adjusted analyses, patients with current depression (n = 18,267) demonstrated significantly higher 10-year and 30-year cardiovascular risk compared to patients with controlled depression (n = 33,383; 10-year: b = 0.59 [95% CI = 0.44,0.74]; 30-year: OR = 1.32 [95% CI = 1.26,1.39]) and patients without depression (n = 19,330; 10-year: b = 0.55 [95% CI = 0.37,0.73]; 30-year: OR = 1.56 [95% CI = 1.48,1.65]). Except for low-density lipoprotein (LDL), patients with current depression had the greatest cardiovascular risk across specific risk factors. CONCLUSIONS: Individuals who had a depression diagnosis and clinically significant depressive symptoms had the greatest cardiovascular risk. Pathways to prevent cardiovascular disease in those with depression might focus on treating depressive symptoms as well as specific uncontrolled cardiovascular risk factors.
Authors: M P Luber; B S Meyers; P G Williams-Russo; J P Hollenberg; T N DiDomenico; M E Charlson; G S Alexopoulos Journal: Am J Geriatr Psychiatry Date: 2001 Impact factor: 4.105
Authors: Lisa F Berkman; James Blumenthal; Matthew Burg; Robert M Carney; Diane Catellier; Marie J Cowan; Susan M Czajkowski; Robert DeBusk; James Hosking; Allan Jaffe; Peter G Kaufmann; Pamela Mitchell; James Norman; Lynda H Powell; James M Raczynski; Neil Schneiderman Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
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