Relation of Persistent Depressive Symptoms to Coronary Artery Calcification in Women Aged 46 to 59 Years

Imke Janssen, Lynda H. Powell, Karen A. Matthews, Mateusz S. Jasielec, Steven M. Hollenberg, Joyce T. Bromberger, Kim Sutton-Tyrrell, Susan A. Everson-Rose

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Abstract

Depressive disorders have been associated with cardiovascular disease (CVD), but the impact of depression on early atherogenesis has not been well described, particularly in women and minorities. The relation between repeated episodes of high depressive symptoms and coronary calcium (CAC) is unknown in women at midlife when depression is common. Participants in the Study of Women's Health Across the Nation Heart study were assessed annually for depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D scale]) over 5 years before CAC assessment and classified as high (CES-D ≥16) or not. CAC, measured by computed tomography, was analyzed as a categorical variable using cumulative logit partial proportional odds models. In these middle-aged women free of CVD and diabetes (194 black, 334 white), high depressive symptoms over 5 years were common; 19% had 1, 9% had 2, and 11% experienced ≥3 episodes. CAC was low; 54% had no CAC, 25% had scores from 0 to 10, and 21% had CAC ≥10 Agatston score. After adjusting for CVD risk factors, women with ≥3 episodes were twice as likely to have significant CAC (≥10 Agatston units) than women with no depressive episodes (odds ratio 2.20, 95% confidence interval 1.13 to 4.28, p = 0.020) with no difference by race. Women with 1 or 2 episodes did not differ from women with no episodes. In conclusion, in healthy women aged 46 to 59 years without clinical CVD or diabetes, persistent depressive symptoms were significantly associated with elevated CAC scores, suggesting that they are more likely to have pathophysiological and behavioral effects on the development of subclinical CVD than does a single episode of elevated depressive symptoms.

Original languageEnglish (US)
Pages (from-to)1884-1889
Number of pages6
JournalAmerican Journal of Cardiology
Volume117
Issue number12
DOIs
StatePublished - Jun 15 2016

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Coronary Vessels
Depression
Calcium
Cardiovascular Diseases
Women's Health
Depressive Disorder
Epidemiologic Studies
Atherosclerosis
Odds Ratio
Tomography
Confidence Intervals

Cite this

Relation of Persistent Depressive Symptoms to Coronary Artery Calcification in Women Aged 46 to 59 Years. / Janssen, Imke; Powell, Lynda H.; Matthews, Karen A.; Jasielec, Mateusz S.; Hollenberg, Steven M.; Bromberger, Joyce T.; Sutton-Tyrrell, Kim; Everson-Rose, Susan A.

In: American Journal of Cardiology, Vol. 117, No. 12, 15.06.2016, p. 1884-1889.

Research output: Contribution to journalArticle

Janssen, I, Powell, LH, Matthews, KA, Jasielec, MS, Hollenberg, SM, Bromberger, JT, Sutton-Tyrrell, K & Everson-Rose, SA 2016, 'Relation of Persistent Depressive Symptoms to Coronary Artery Calcification in Women Aged 46 to 59 Years', American Journal of Cardiology, vol. 117, no. 12, pp. 1884-1889. https://doi.org/10.1016/j.amjcard.2016.03.035
Janssen, Imke ; Powell, Lynda H. ; Matthews, Karen A. ; Jasielec, Mateusz S. ; Hollenberg, Steven M. ; Bromberger, Joyce T. ; Sutton-Tyrrell, Kim ; Everson-Rose, Susan A. / Relation of Persistent Depressive Symptoms to Coronary Artery Calcification in Women Aged 46 to 59 Years. In: American Journal of Cardiology. 2016 ; Vol. 117, No. 12. pp. 1884-1889.
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abstract = "Depressive disorders have been associated with cardiovascular disease (CVD), but the impact of depression on early atherogenesis has not been well described, particularly in women and minorities. The relation between repeated episodes of high depressive symptoms and coronary calcium (CAC) is unknown in women at midlife when depression is common. Participants in the Study of Women's Health Across the Nation Heart study were assessed annually for depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D scale]) over 5 years before CAC assessment and classified as high (CES-D ≥16) or not. CAC, measured by computed tomography, was analyzed as a categorical variable using cumulative logit partial proportional odds models. In these middle-aged women free of CVD and diabetes (194 black, 334 white), high depressive symptoms over 5 years were common; 19{\%} had 1, 9{\%} had 2, and 11{\%} experienced ≥3 episodes. CAC was low; 54{\%} had no CAC, 25{\%} had scores from 0 to 10, and 21{\%} had CAC ≥10 Agatston score. After adjusting for CVD risk factors, women with ≥3 episodes were twice as likely to have significant CAC (≥10 Agatston units) than women with no depressive episodes (odds ratio 2.20, 95{\%} confidence interval 1.13 to 4.28, p = 0.020) with no difference by race. Women with 1 or 2 episodes did not differ from women with no episodes. In conclusion, in healthy women aged 46 to 59 years without clinical CVD or diabetes, persistent depressive symptoms were significantly associated with elevated CAC scores, suggesting that they are more likely to have pathophysiological and behavioral effects on the development of subclinical CVD than does a single episode of elevated depressive symptoms.",
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AB - Depressive disorders have been associated with cardiovascular disease (CVD), but the impact of depression on early atherogenesis has not been well described, particularly in women and minorities. The relation between repeated episodes of high depressive symptoms and coronary calcium (CAC) is unknown in women at midlife when depression is common. Participants in the Study of Women's Health Across the Nation Heart study were assessed annually for depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D scale]) over 5 years before CAC assessment and classified as high (CES-D ≥16) or not. CAC, measured by computed tomography, was analyzed as a categorical variable using cumulative logit partial proportional odds models. In these middle-aged women free of CVD and diabetes (194 black, 334 white), high depressive symptoms over 5 years were common; 19% had 1, 9% had 2, and 11% experienced ≥3 episodes. CAC was low; 54% had no CAC, 25% had scores from 0 to 10, and 21% had CAC ≥10 Agatston score. After adjusting for CVD risk factors, women with ≥3 episodes were twice as likely to have significant CAC (≥10 Agatston units) than women with no depressive episodes (odds ratio 2.20, 95% confidence interval 1.13 to 4.28, p = 0.020) with no difference by race. Women with 1 or 2 episodes did not differ from women with no episodes. In conclusion, in healthy women aged 46 to 59 years without clinical CVD or diabetes, persistent depressive symptoms were significantly associated with elevated CAC scores, suggesting that they are more likely to have pathophysiological and behavioral effects on the development of subclinical CVD than does a single episode of elevated depressive symptoms.

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