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Stroke, CHD more likely in black adults with depressive symptoms
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New data from the Jackson Heart Study indicate that blacks with symptoms of major depression are at increased risk for incident stroke and may be at increased risk for incident CHD.
Although some links have been established between depression and CV risk, those studies were conducted in predominantly white populations, and the link in blacks was not known, according to the study background.
Researchers analyzed 3,309 black participants from the Jackson Heart Study without stroke at baseline. They were evaluated for depressive symptoms between 2000 and 2004 and followed for 10 years.
In the total cohort, 22.3% had depressive symptoms at baseline, whereas of the 3,178 participants without CHD at baseline, 21.8% had depressive symptoms, Emily C. O’Brien, PhD, and colleagues reported.
Emily C. O'Brien
In unadjusted models, 10-year risk for stroke was similar in those with any depressive symptoms vs. those with none (3.7% vs. 2.6%; P = .12), but 10-year risk for CHD was elevated among those with any depressive symptoms (5.6% vs. 3.6%; P = .03). The difference in CHD risk remained after adjusting for behavioral and clinical risk factors but not after adjusting for coping strategies, according to the researchers.
When O’Brien, medical instructor at Duke Clinical Research Institute, and colleagues compared participants with and without major depressive symptoms in an adjusted model, they found that participants with symptoms of major depression had nearly twice the stroke risk (HR = 1.95; 95% CI, 1.02-3.71).
They determined that a 1-standard deviation increase in the Center for Epidemiologic Studies Depression Scale conferred a 30% increase in adjusted risk for incident stroke (P = .04).
Risk for CHD was elevated among participants with any depressive symptoms after adjustment for CHD risk score, socioeconomic status, behavioral risk factors and antidepressant use (HR = 1.55; 95% CI, 1.02-2.35) but not after further adjustment for coping strategies (HR = 1.41; 95% CI, 0.9-2.21), the researchers found. The same was true for those with major depressive symptoms (HR before adjustment for coping strategies = 1.9; 95% CI, 1.13-3.2; HR after adjustment = 1.67; 95% CI, 0.95-2.93).
“African Americans have higher rates of severe depression yet lower rates of treatment compared with white populations,” O’Brien said in a press release. “We need better communication between providers and patients to support early screening and shared decision making to reduce the rate of depression in this population. … The need for greater understanding of associations between depressive symptoms and [CV] outcomes in African Americans is particularly important in light of reported racial disparities in disease severity, timely diagnosis and use of drug therapy.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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