Numerous studies have found that depression was a strong independent risk factor for
incident coronary heart disease (CHD), with increasing risk in those with higher levels
of depressive symptoms. The association between measures of inflammation (C-reactive
protein, interleukin-6, and soluble intracellular adhesion molecule-1), depressive
symptoms, and CHD incidence was examined in 1,794 subjects of the population-based
Canadian Nova Scotia Health Survey. There were 152 incident CHD events (8.5%; 141
nonfatal, 11 fatal) during the 15,514 person-years of observation (incidence rate
9.8 events/1,000 person-years). Depression and inflammation were correlated at baseline
and each significantly predicted CHD in separate models. When both risk factors were
in the same model, each remained significant. The association between depressed group
by the Center for Epidemiological Studies-Depression scale (score ≥10 vs 0 to 9) and
CHD incidence (hazard rate 1.60, 95% confidence interval 1.12 to 2.27) was not reduced
by the addition of inflammatory markers to the model (hazard rate 1.59, 95% confidence
interval 1.12 to 2.26). Findings were similar after adjustment for aspirin, lipid-lowering
medication, or antidepressant use, and the association did not vary by gender, smoking
status, age, obesity, cardiovascular medication use, or antidepressant use. In conclusion,
increased inflammation explained only a very small proportion of the association between
depression and incident CHD.
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Article Info
Publication History
Published online: January 27, 2009
Accepted:
November 13,
2008
Received in revised form:
November 13,
2008
Received:
August 29,
2008
Footnotes
This study was supported by Grants HL-088117, HL-076857, HL-084034, HL-072866, and HL-04458 from the National Heart, Lung, and Blood Institute, Bethesda, MD; and Grant UL1 RR024156 from the National Center for Research Resources, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research, Bethesda, MD. The National Health and Welfare of Canada, the Nova Scotia Department of Health, and the Heart and Stroke Foundation of Canada, Ottawa, Canada, supported the original data collection. The study sponsors had no role in the study design, collection, analysis, writing, or interpretation of data.
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Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
