Relationships of Anxiety and Depression with Cardiovascular Health in Youth with Normal Weight to Severe Obesity

Amy C Gross, Alexander M. Kaizer, Justin R Ryder, Claudia K Fox, Kyle Rudser, Donald R Dengel, Aaron S Kelly

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: To evaluate the relationships of depression and anxiety symptoms with cardiovascular disease (CVD) risk factors and measures of vascular health in youth. Study design: Participants (n = 202) were 8- to 18-year-olds from a cross-sectional study evaluating cardiovascular health across a wide range of body mass index values (normal weight to severe obesity). CVD risk measurement included blood pressure, fasting lipids, glucose, insulin, carotid artery intima-media thickness, compliance and distensibility, brachial artery flow-mediated dilation, carotid-radial artery pulse wave velocity, body fat percentage, and a metabolic syndrome cluster score. Anxiety and depression symptoms were self-reported on the Screen for Child Anxiety Related Disorders and Center for Epidemiological Studies Depression Scale for Children. Two sets of adjustment variables were used in evaluation of differences between those with and without anxiety or depression symptomatology for the CVD risk factor and vascular outcomes. The first set included adjustment for Tanner stage, sex, and race; the second was additionally adjusted for percent body fat. Results: Anxiety was not significantly associated with CVD risk factors or vascular health in either model. Depression was associated with high-density lipoprotein cholesterol, triglycerides, and metabolic syndrome cluster score; these relationships were attenuated when accounting for percent body fat. Conclusions: When accounting for body fat, we found no clear relationship of self-reported depression or anxiety symptoms with CVD risk factors or vascular health in youth.

Original languageEnglish (US)
Pages (from-to)85-91
Number of pages7
JournalJournal of Pediatrics
StatePublished - Aug 2018

Bibliographical note

Funding Information:
Funded by the National Heart, Lung, and Blood Institute/NIH (R01HL110957), the National Center for Advancing Translational Sciences/NIH (UL1TR000114), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/NIH NORC (P30 DK050456). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A.K. receives research support (drug/placebo) from Astra Zeneca Pharmaceuticals and serves as a consultant for Novo Nordisk, Orexigen, and Vivus Pharmaceuticals but does not accept personal or professional income for these activities. C.F. receives research support from Novo Nordisk. The other authors declare no conflicts of interest.

Publisher Copyright:
© 2018 Elsevier Inc.


  • cardiovascular disease
  • mental health
  • pediatrics


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