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Dhingra R, He F, Al-Shaar L, Saunders EFH, Chinchilli VM, Yanosky JD, Liao D. Cardiovascular disease burden is associated with worsened depression symptoms in the U.S. general population. J Affect Disord 2023; 323:866-874. [PMID: 36566933 DOI: 10.1016/j.jad.2022.12.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/19/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) and depression are the leading causes of disability in the U.S. Using five cycles (2009-2018) of the U.S. National Health and Nutrition Examination Survey, we examined the cross-sectional association between CVD risk factor burden and depression severity in nonpregnant adults with no history of CVD events. METHODS With at least 3000 participants per cycle, the overall N was 18,175. CVD risk factors were ascertained through self-report, lab tests, or medications. The sum of hypertension, diabetes, dyslipidemia, and current smoking represented a CVD risk score variable (range: 0-4). Depression severity was assessed using scores on the 9-item patient health questionnaire: 0-9 (none-mild) and 10-27 (moderate-to-severe). Logistic regression models were performed to investigate the association between CVD risk score categories and moderate-to-severe depression. Cycle-specific odds ratios (OR) were meta-analyzed to obtain a pooled OR (95 % CI) (Q-statistic p > 0.05). RESULTS Compared to participants with no CVD risk factors, participants with risk scores of 1, 2, 3, and 4, had 1.28 (0.92-1.77), 2.18 (1.62-2.94), 2.53 (1.86-3.49), 2.97 (1.67-5.31) times higher odds of moderate-to-severe depression, respectively, after adjusting for socio-demographics and antidepressant use (linear trend p < 0.0001). This relationship persisted after additionally adjusting for lifestyle variables. LIMITATIONS NHANES data is cross-sectional and self-reported, thus preventing causal assessments and leading to potential recall bias. CONCLUSIONS Among U.S. adults, CVD risk factor burden was associated with worsened depression symptoms. Integrated mental and physical healthcare services could improve risk stratification among persons with CVD and depression, possibly reducing long-term disability and healthcare costs.
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Affiliation(s)
- Radha Dhingra
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Laila Al-Shaar
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Vernon M Chinchilli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
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Lorem GF, Opdal IM, Wilsgaard T, Schirmer H, Løchen ML, Olsen IP, Steigen T, Rognmo K. Assessment of mental health trajectories before and after myocardial infarction, atrial fibrillation or stroke: analysis of a cohort study in Tromsø, Norway (Tromsø Study, 1994-2016). BMJ Open 2022; 12:e052948. [PMID: 35365517 PMCID: PMC8977765 DOI: 10.1136/bmjopen-2021-052948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The increased survival rate of cardiovascular disease (CVD) implies a higher proportion of individuals who live with CVD. Using data from the Tromsø Study, we aimed to investigate mental health symptom trajectories before and after myocardial infarction, atrial fibrillation or stroke in a general population and to explore factors that contribute to the association. DESIGN Cohort study. SETTING Sample drawn from inhabitants of the municipality of Tromsø, Norway, who participated in the Tromsø Study (1994-2016). PARTICIPANTS A total of 18 719 participants (52.3% women) were included, and of these 2098 (32.9% women) were diagnosed with myocardial infarction, 1896 (41.9% women) with atrial fibrillation and 1263 (42.9% women) with stroke. PRIMARY OUTCOME MEASURES Mental health symptoms were assessed using the Hopkins Symptom Checklist-10 and the Conor Mental Health Index. RESULTS The participants who were diagnosed with either myocardial infarction or stroke had a significant monotonous increase in mental health symptoms before myocardial infarction (p=0.029) and stroke (p=0.029) that intensified at the time of diagnosis. After the event, the study found a higher prevalence of mental health symptoms with a decline in symptom levels over time for myocardial infarction (p<0.001) and stroke (p=0.004), but not for atrial fibrillation (before: p=0.180, after: p=0.410). The risk of elevated mental health symptoms with myocardial infarction, atrial fibrillation and stroke was associated with sex (p<0.001), age (p<0.01), physical activity (p<0.001), diabetes (p<0.05) and other comorbidities (p<0.001). CONCLUSION The study indicates that mental health problems among individuals with myocardial infarction, atrial fibrillation and stroke may have started to develop several years before the cardiovascular event and suggests that successful CVD rehabilitation may need to consider previous life factors. Future research is recommended to examine whether health promotion measures in a general population also create mental health resilience after a CVD event.
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Affiliation(s)
| | - Ida Marie Opdal
- Department of Psychology, UiT The Arctic University of Norway, Tromso, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, University of Oslo Faculty of Medicine, Lørenskog, Norway
- Department of Cardiology, Akershus University Hospital, Lorenskog, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Cardiology, University Hospital of North Norway, UNN, Tromso, Norway
| | - Ingrid Petrikke Olsen
- Department of Gynaecology and Obstetrics, Finnmark Hospital Trust, Hammerfest, Norway
- Institute of Clinical Medicine, University of Tromso, Tromso, Norway
| | - Terje Steigen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Cardiology, University Hospital of North Norway, UNN, Tromso, Norway
| | - Kamilla Rognmo
- Department of Psychology, UiT The Arctic University of Norway, Tromso, Norway
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Karamali M, Gholizadeh M. The effects of coenzyme Q10 supplementation on metabolic profiles and parameters of mental health in women with polycystic ovary syndrome. Gynecol Endocrinol 2022; 38:45-49. [PMID: 34664527 DOI: 10.1080/09513590.2021.1991910] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Evaluating the impact of coenzyme Q10 (CoQ10) supplementation on hormonal indices, mental health, and biomarkers of inflammatory responses and oxidative stress among female patients suffering from polycystic ovary syndrome (PCOS). METHODS The present double-blinded, placebo-controlled randomized clinical trial consisted of 55 PCOS women (aged 18-40 years old), who were randomized into groups receiving 100 mg/day of CoQ10 (28 cases) or placebo (27 cases) for 12 weeks. RESULTS The supplementation of CoQ10 decreased significantly the scores of Beck Depression Inventory (BDI) (p = .03) and Beck Anxiety Inventory (BAI) (p = .01) and high-sensitivity C-reactive protein (hs-CRP) level (p = .005) when comparing with the placebo group. Moreover, CoQ10 group exhibited a significant drop in total testosterone (p = .004), dehydroepiandrosterone sulfate (DHEAS) (p < .001), hirsutism (p = .002) and malondialdehyde (MDA) (p = .001) levels in the serum, and a significant rise in sex hormone-binding globulin (SHBG) (p < .001) and total antioxidant capacity (TAC) (p < .001) levels in the serum than the placebo group. CONCLUSIONS 12-week supplementation of CoQ10 to PCOS women showed beneficial impact on BDI, BAI, hs-CRP, total testosterone, DHEAS, hirsutism, SHBG, TAC and MDA levels.
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Affiliation(s)
- Maryam Karamali
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Gholizadeh
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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van Zutphen EM, Kok AAL, Rhebergen D, Huisman M, Beekman ATF. The joint effects of clinically relevant depressive symptoms and cardiovascular risk factors on incident cardiovascular disease among older adults in the community. J Psychosom Res 2021; 149:110572. [PMID: 34332270 DOI: 10.1016/j.jpsychores.2021.110572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine if there is a synergistic effect between clinically relevant depressive symptoms and cardiovascular risk factors that disproportionately increases the risk of cardiovascular disease (CVD) among older adults with depressive symptoms. METHODS Data were obtained from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study. N = 3091 respondents with up to seven years of follow-up were included. Incident CVD was based on self-report, medication use, general practitioners' diagnoses and causes of death. A score of ≥16 points on the Center for Epidemiological Studies Depression Scale indicated clinically relevant depressive symptoms. Risk factors included were sex, education, obesity, smoking, alcohol use, physical inactivity and diabetes mellitus. Data were analysed with Cox regression models. Measures of multiplicative and additive interaction were calculated to determine if the presence of both depressive symptoms and a risk factor amplified the risk of CVD. RESULTS Of all participants, 12.6% had clinically relevant depressive symptoms and, after a median follow-up of six years, 15.7% developed CVD. Only the additive interaction between physical inactivity and depressive symptoms was statistically significant and explained 40.6% of the CVD risk among inactive persons with depressive symptoms. CONCLUSION In the general population, we did not detect synergistic effects for most risk factors. However, older adults with clinically relevant depressive symptoms and a physically inactive lifestyle appeared to be at a particularly high risk to develop CVD and may represent an important target for cardiovascular prevention.
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Affiliation(s)
- Elisabeth M van Zutphen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands.
| | - Almar A L Kok
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Didericke Rhebergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Mental Health Care Institute GGZ Centraal, Amersfoort, the Netherlands.
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Sociology, Vrije Universiteit, Amsterdam, the Netherlands.
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands.
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Dhaibar HA, Cruz-Topete D. Predisposition of Women to Cardiovascular Diseases: A Side-Effect of Increased Glucocorticoid Signaling During the COVID-19 Pandemic? Front Glob Womens Health 2021; 2:606833. [PMID: 34816180 PMCID: PMC8593983 DOI: 10.3389/fgwh.2021.606833] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/25/2021] [Indexed: 01/22/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has created a significant health crisis worldwide. To mitigate this disease's spread, "social distancing" and "shelter in place" have been implemented. While these actions have been critical to controlling the pandemic, they have short- and long-term mental health consequences due to increased stress. There is a strong association between mental stress and cardiovascular disease (CVD). Young women (pre-menopausal) are at high risk of developing CV events in response to mental stress compared to age-matched men. The mechanisms underlying women's increased reactivity and response to stress are mostly unknown. The present review summarizes the known physiological consequences of mental stress in women's CV health and the latest molecular findings of the actions of the primary stress hormones, glucocorticoids, on the CV system. The current data suggest a clear link between psychological stress and heart disease, and women have an increased sensitivity to the harmful effects of stress hormone signaling imbalances. Therefore, it is expected that with the given unprecedented levels of stress associated with the COVID-19 pandemic, women's CV health will be significantly compromised. It is critical to widen our understanding of the direct contribution of mental stress to CVD risk in women and to identify biochemical markers with predictive value for CVD in female patients with/without cardiovascular conditions who have experienced significant mental stress during the current pandemic.
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Affiliation(s)
| | - Diana Cruz-Topete
- Department of Molecular and Cellular Physiology, Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States
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Park SJ, Lee MG, Jo M, Kim G, Park S. Joint effect of depression and health behaviors or conditions on incident cardiovascular diseases: A Korean population-based cohort study. J Affect Disord 2020; 276:616-622. [PMID: 32871693 DOI: 10.1016/j.jad.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/26/2020] [Accepted: 07/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The precise relationships among depression, risk factors for cardiovascular disease (CVD), and incident CVD remain uncertain. This study examined the joint effect of depression and other CVD risk factors on the incidence of CVD. METHODS We conducted a prospective cohort study using South Korea's National Health Insurance Service-National Sample Cohort (NHIS-NSC). To estimate incident CVD, 199,544 participants without CVD diagnosed with depression between 2003 and 2005 were followed through 2013. The clinician's diagnosis used measurements for depression, CVD risk factors, and CVD. RESULTS Controlling for other CVD risk factors, depressed individuals had a higher risk for ischemic heart disease (AHR, 1.01; 99%%CI, 1.01-1.50) and other forms of heart disease likely related to atherosclerosis (AHR, 1.43; 99%%CI, 1.13-1.82). There were no statistically significant interactions between depression and CVD risk factors. However, when depression was comorbid with overweight or diabetes, there was a higher risk for incident ischemic heart disease, as compared to depression or CVD risk factors alone. For other forms of heart disease likely related to atherosclerosis, the coexistence of depression and physical inactivity or overweight showed a similar pattern to that shown in ischemic heart disease. LIMITATIONS The severity of depression was not reported for depressed patients, and our dataset provided a limited number of covariates. Also, the self-reported health behavior data may be biased. CONCLUSION As depression could be a significant predictor of incident CVD independently with other CVD risk factors, professionals should recognize and manage depression as a major CVD risk factor.
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Affiliation(s)
- Se Jin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Min Geu Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Minkyung Jo
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Gyurin Kim
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea.
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Carroll AJ, Huffman MD, Zhao L, Jacobs DR, Stewart JC, Kiefe CI, Brunner W, Liu K, Hitsman B. Associations between depressive symptoms, cigarette smoking, and cardiovascular health: Longitudinal results from CARDIA. J Affect Disord 2020; 260:583-591. [PMID: 31539696 PMCID: PMC6931258 DOI: 10.1016/j.jad.2019.09.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/08/2019] [Accepted: 09/08/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Depression is associated with increased risk of incident and recurrent cardiovascular disease, while the association between depression and cardiovascular health (CVH) remains unknown. Because the natural course of depression varies widely, different patterns of depression, as well as co-occurring factors such as cigarette smoking, may influence this relationship. We examined potential interactions between longitudinal patterns of depression and smoking with CVH. METHODS Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we modeled trajectories of depression (Center for Epidemiologic Studies Depression scale scores; Years 5, 10, 15, 20) and smoking (cigarettes/day; Years 0, 2, 5, 7, 10, 15, 20). We calculated a modified American Heart Association (AHA) CVH Score (weight, blood glucose, cholesterol, blood pressure, physical activity, and diet; Year 20); higher scores indicate better CVH. Generalized linear models evaluated associations between depression trajectories, smoking trajectories, and their interaction with CVH Score. RESULTS The depression trajectory x smoking trajectory interaction was not associated with CVH Score, but main effects of depression trajectory (p < .001) and smoking trajectory (p < .001) were observed. Participants with patterns of subthreshold depression (β = -0.26, SE=0.08), increasing depression (β = -0.51 SE = 0.14), and high depression (β = -0.65, SE = 0.32) had lower CVH Scores than those without depression. Compared to never smokers, participants who quit smoking had higher CVH Scores (β = 0.38, SE = 0.11), while participants with the greatest smoking exposure had lower CVH Scores (β = -0.49, SE = 0.22). LIMITATIONS CVH Scores were adapted from the AHA guidelines based on the available CARDIA data. CONCLUSIONS Deleterious depression and smoking trajectories are independently but not synergistically associated with worse CVH.
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Affiliation(s)
- Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Cardiac Surgery, Department of Surgery, Northwestern Medicine, Chicago, IL, USA.
| | - Mark D Huffman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Food Policy, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Lihui Zhao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David R Jacobs
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Wendy Brunner
- Center for Rural Community Health, Bassett Resarch Institute, Cooperstown, NY, USA
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Polanka BM, Berntson J, Vrany EA, Stewart JC. Are Cardiovascular Risk Factors Stronger Predictors of Incident Cardiovascular Disease in U.S. Adults With Versus Without a History of Clinical Depression? Ann Behav Med 2019; 52:1036-1045. [PMID: 30418524 DOI: 10.1093/abm/kay007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Several mechanisms underlying the depression-to-cardiovascular disease (CVD) relationship have been proposed; however, few studies have examined whether depression promotes CVD through potentiating traditional cardiovascular risk factors. Purpose To test the combined influence of three cardiovascular risk factors and lifetime depressive disorder on incident CVD in a large, diverse, and nationally representative sample of U.S. adults. Methods Respondents were 26,840 adults without baseline CVD who participated in Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Lifetime depressive disorder, tobacco use, hypertension, and incident CVD were determined from structured interviews, and body mass index (BMI) was computed from self-reported height and weight. Results Logistic regression models predicting incident CVD (1,046 cases) revealed evidence of moderation, as the interactions between lifetime depressive disorder and current tobacco use (p = .002), hypertension (p < .001), and BMI (p = .031) were significant. The Former Tobacco Use × Lifetime Depressive Disorder interaction was not significant (p = .85). In models stratified by lifetime depressive disorder, current tobacco use (OR = 1.78, 95% CI = 1.36-2.32, p < .001 vs. OR = 1.41, 95% CI = 1.24-1.60, p < .001), hypertension (OR = 2.46, 95% CI = 1.98-3.07, p < .001 vs. OR = 1.39, 95% CI = 1.28-1.51, p < .001), and BMI (OR = 1.10, 95% CI = 1.01-1.20, p = .031 vs. OR = 1.03, 95% CI = 0.99-1.07, p = .16) were stronger predictors of incident CVD in adults with versus without a lifetime depressive disorder. Conclusions Our findings suggest that amplifying the atherogenic effects of traditional cardiovascular risk factors may be yet another candidate mechanism that helps to explain the excess CVD risk of people with depression.
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Affiliation(s)
- Brittanny M Polanka
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
| | - Jessica Berntson
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
| | - Elizabeth A Vrany
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
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Hamieh N, Meneton P, Wiernik E, Limosin F, Zins M, Goldberg M, Melchior M, Lemogne C. Depression, treatable cardiovascular risk factors and incident cardiac events in the Gazel cohort. Int J Cardiol 2019; 284:90-95. [DOI: 10.1016/j.ijcard.2018.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/12/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
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Jamilian M, Foroozanfard F, Kavossian E, Aghadavod E, Amirani E, Mahdavinia M, Mafi A, Asemi Z. Carnitine and chromium co-supplementation affects mental health, hormonal, inflammatory, genetic, and oxidative stress parameters in women with polycystic ovary syndrome. J Psychosom Obstet Gynaecol 2019:1-9. [PMID: 30835597 DOI: 10.1080/0167482x.2018.1557144] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/25/2018] [Accepted: 12/04/2018] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of the co-administration of carnitine and chromium on mental health, hormonal, inflammatory and genetic parameters in women with PCOS. METHODS This randomized, double-blinded, placebo-controlled clinical trial was conducted on 54 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 1000 mg/d carnitine plus 200 µg/d chromium as chromium picolinate (n = 26) or placebo (n = 27) for 12 weeks. RESULTS Carnitine and chromium co-supplementation, compared with the placebo, significantly improved beck depression inventory (β - 0.84; 95% CI, -1.51, -0.17; p = 0.01), general health questionnaire scores (β - 1.13; 95% CI, -2.13, -0.14; p = 0.02) and depression anxiety and stress scale scores (β - 0.96; 95% CI, -0.78, -0.14; p = 0.02). Participants who received carnitine plus chromium supplements had significantly lower total testosterone (β - 0.15 ng/mL; 95% CI, -0.24, -0.06; p = 0.002), hirsutism (β - 0.48; 95% CI, -0.91, -0.06; p = 0.02), high-sensitivity C-reactive protein (hs-CRP) (β - 1.02 mg/L; 95% CI, -1.79, -0.25; p = 0.01), and malondialdehyde (MDA) levels (β - 0.38 µmol/L; 95% CI, -0.56, -0.20; p < 0.001), and higher total antioxidant capacity (TAC) levels (β 107.18 mmol/L; 95% CI, 44.24, 170.12; p = 0.001) compared with the placebo. Moreover, carnitine and chromium co-supplementation upregulated gene expression of interleukin-6 (IL-6) (p = 0.02) and tumor necrosis factor alpha (TNF-α) (p = 0.02) compared with the placebo. CONCLUSION Overall, the co-administration of carnitine and chromium for 12 weeks to women with PCOS had beneficial effects on mental health parameters, serum total testosterone, mF-G scores, hs-CRP, TAC and MDA levels, and gene expression of IL-6 and TNF-α.
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Affiliation(s)
- Mehri Jamilian
- a Traditional and Complementary Medicine Research Center , Arak University of Medical Sciences , Arak , Iran
| | - Fatemeh Foroozanfard
- b Department of Gynecology and Obstetrics, School of Medicine , Kashan University of Medical Sciences , Kashan , Iran
| | - Elham Kavossian
- b Department of Gynecology and Obstetrics, School of Medicine , Kashan University of Medical Sciences , Kashan , Iran
| | - Esmat Aghadavod
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
| | - Elaheh Amirani
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
| | - Mostafa Mahdavinia
- d Department of Dermatology, Razi Hospital , Tehran University of Medical Sciences , Tehran , Iran
| | - Alireza Mafi
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
| | - Zatollah Asemi
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
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Brewer LC, Redmond N, Slusser JP, Scott CG, Chamberlain AM, Djousse L, Patten CA, Roger VL, Sims M. Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study. J Am Heart Assoc 2018; 7:JAHA.118.008855. [PMID: 29871857 PMCID: PMC6015384 DOI: 10.1161/jaha.118.008855] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Ideal cardiovascular health metrics (defined by the American Heart Association Life's Simple 7 [LS7]) are suboptimal among blacks, which results in high risk of cardiovascular disease. We examined the association of multiple stressors with LS7 components among blacks. Methods and Results Using a community‐based cohort of blacks (N=4383), we examined associations of chronic stress, minor stressors, major life events, and a cumulative stress score with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting plasma glucose) and an LS7 composite score. Multivariable logistic regression assessed the odds of achieving intermediate/ideal levels of cardiovascular health adjusted for demographic, socioeconomic, behavioral, and biomedical factors. The LS7 components with the lowest percentages of intermediate/ideal cardiovascular health levels were diet (39%), body mass index (47%), and physical activity (51%). Higher chronic, minor, and cumulative stress scores were associated with decreased odds (odds ratio [OR]) of achieving intermediate/ideal levels for smoking (OR [95% confidence interval], 0.80 [0.73–0.88], 0.84 [0.75–0.94], and 0.81 [0.74–0.90], respectively). Participants with more major life events had decreased odds of achieving intermediate/ideal levels for smoking (OR, 0.84; 95% confidence interval, 0.76–0.92) and fasting plasma glucose (OR, 0.90; 95% confidence interval, 0.82–0.98). Those with higher scores for minor stressors and major life events were less likely to achieve intermediate or ideal LS7 composite scores (OR [95% confidence interval], 0.89 [0.81–0.97] and 0.91 [0.84–0.98], respectively). Conclusions Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall cardiovascular health (LS7 composite score), specific behaviors (smoking), and biological factors (fasting plasma glucose).
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Affiliation(s)
| | - Nicole Redmond
- National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, MD
| | - Joshua P Slusser
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Luc Djousse
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Veronique L Roger
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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12
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Lerman S, Jung M, Arredondo EM, Barnhart JM, Cai J, Castañeda SF, Daviglus ML, Espinoza RA, Giachello AL, Molina KM, Perreira K, Salgado H, Wassertheil-Smoller S, Kaplan RC. Religiosity prevalence and its association with depression and anxiety symptoms among Hispanic/Latino adults. PLoS One 2018; 13:e0185661. [PMID: 29415030 PMCID: PMC5802430 DOI: 10.1371/journal.pone.0185661] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/16/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Religion plays an important role in the lives of people in the United States. We examined the prevalence of religiosity among Hispanic/Latinos in four regions of the United States and looked at its correlation to depression and anxiety symptoms. DESIGN The population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of Hispanic/Latino adults (N = 16,415) ages 18-74 in four US cities from June 2008 to June 2011. Participants with complete data on religiosity (i.e., religious affiliation, frequency of attending religious activities and importance of religion), depression (assessed with the CESD-10), and trait anxiety (assessed with the STAI-10) were included in the present study. Distribution of religiosity is described by sociodemographic characteristics. Associations between religiosity with depression and anxiety were examined with logistic regression models controlling for sex, age group, education, Hispanic/Latino background, clinical center, and nativity. RESULTS The majority of the population (89.5%) reported having a religious affiliation. Weekly attendance at religious activities was reported by 41.6% of participants, while 20.6% did not attend any religious activities. Religion was very important to 63.9% and not at all important to 6.7% of the population. The CES-D scores and trait anxiety scores were not significantly related in the overall group to frequency of attending religious activity or perceived importance of religion. However, in age-stratified analyses, among older individuals (65+ years old) reporting "never" participating in religious activities compared to more than once per week was associated with an 80% higher likelihood of having high depressive symptomatology. Similarly, in the older age group, no religious affiliation or reporting that religion is "not at all important" was associated with greater anxiety symptomatology. CONCLUSION Religiosity varied by Hispanic/Latino background. Lack of religiosity was associated with elevated depressive or anxiety symptomology in older adults but not in young or middle-aged adults.
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Affiliation(s)
- Shir Lerman
- University of Massachusetts Medical School, Division of Preventive & Behavioral Medicine, Worcester, MA, United States of America
| | - Molly Jung
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Elva M. Arredondo
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Janice M. Barnhart
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Jianwen Cai
- University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, NC, United States of America
| | - Sheila F. Castañeda
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Martha L. Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Department of Medicine, Chicago, IL, United States of America
| | - Rebeca A. Espinoza
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Aida L. Giachello
- University of Illinois at Chicago, Department of Psychology, Chicago, IL, United States of America
| | - Kristine M. Molina
- University of Illinois at Chicago, Department of Psychology, Chicago, IL, United States of America
| | - Krista Perreira
- University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, NC, United States of America
| | - Hugo Salgado
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Sylvia Wassertheil-Smoller
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Robert C. Kaplan
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
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13
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Lemche AV, Chaban OS, Lemche E. Depression contributing to dyslipidemic cardiovascular risk in the metabolic syndrome. J Endocrinol Invest 2017; 40:539-546. [PMID: 28012071 PMCID: PMC5390000 DOI: 10.1007/s40618-016-0601-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/11/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Triglycerides are considered an emerging risk factor for cardiovascular mortality. Recent evidence relating depression and metabolic syndrome (MetS) implicated triglyceride levels. We thus investigated interrelations of self-reported depression severity (Zung) and MetS-related biological measures with CVD risk estimates in MetS patients. METHODS N = 101 patients fulfilling International Diabetes Federation criteria for MetS from a nationwide sampled treatment cohort for MetS with familial T2DM risk or manifest T2DM in a Ukrainian governmental health care system were participants. Both laboratory and non-laboratory measures were included. Recent European cardiological SCORE system CVD risk estimates were used as outcome variables. RESULTS Following correlation matrix, we entered all variables into principal component analysis (PCA; 76.7% explained variance), followed by hierarchical regression and structural equation modeling (SEM). The PCA suggested a one-factor solution, where the latent variable showed highest loadings of SCORE risk estimates, triglycerides, depression severity, and pulse pressure. A comprehensive SEM was adjusted with 92.7% explained variance: overall CVD risk related to depression, pulse pressure, triglycerides, and fasting glucose. CONCLUSION The findings in this MetS sample suggest that triglycerides and depression severity are the key variables among MetS biomarkers in cross-sectionally associating with the fatal and total SCORE risk estimates in MetS.
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Affiliation(s)
| | - O. S. Chaban
- Section of Psychosomatic Medicine, Bogomolets National Medical University, Kiev, Ukraine
| | - E. Lemche
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Box PO 69, De Crespigny Park, London, SE5 8AF UK
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14
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Wenger N. Tailoring cardiovascular risk assessment and prevention for women: One size does not fit all. Glob Cardiol Sci Pract 2017; 2017:e201701. [PMID: 28971101 PMCID: PMC5621718 DOI: 10.21542/gcsp.2017.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Nanette Wenger
- Professor of Medicine (Cardiology) Emeritus, Emory University School of Medicine Consultant, Emory Heart and Vascular Center, Atlanta, USA.,Founding Consultant, Emory Women's Heart Center
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15
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Donnelly TT, Al Suwaidi JM, Al-Qahtani A, Asaad N, Qader NA, Singh R, Fung TS, Mueed I, Sharara S, El Banna N, Omar S. Depression in Cardiovascular Patients in Middle Eastern Populations: A Literature Review. J Immigr Minor Health 2016; 17:1259-76. [PMID: 24923859 DOI: 10.1007/s10903-014-0052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Cardiovascular disease (CVD) is increasing in Middle Eastern countries. Depression is associated with increased morbidity and mortality rates among cardiovascular (CV) patients. Early detection of and intervention for depression among CV patients can reduce morbidity and mortality and save health care costs. Public information on mental health care needs of Arab CV patients living in Middle East regions is scattered and limited. This literature review surveyed and summarized research studies to learn what is known about the relationship between depression and CVD in Middle Eastern populations. The information will raise awareness among health care professionals and policy makers regarding the clinical significance of depression in Arab CV patients. It might contribute to development of culturally appropriate and effective mental health care services. Multiple databases were searched and 60 articles were assessed, including studies that investigated depression in Arab CV patient populations, physiological mechanisms of depression-CVD comorbidity, and intervention strategies that affect CV risk in depressed Arab patients. We discuss the extent to which this issue has been explored in Arab populations living in Middle East regions and Arab populations living abroad. We recommend that more comprehensive and in-depth research studies be conducted with Arab cardiac patients to enable implementation of culturally appropriate and effective mental health care interventions.
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Affiliation(s)
- Tam Truong Donnelly
- University of Calgary-Qatar, P.O. Box 23133, Al Rayyan Campus, Al Forousiya Road, Doha, Qatar,
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17
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Robins JL, Elswick RK, Sturgill J, McCain NL. The Effects of Tai Chi on Cardiovascular Risk in Women. Am J Health Promot 2016; 30:613-622. [PMID: 26305613 DOI: 10.4278/ajhp.140618-quan-287] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 03/03/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE This study examined the effects of tai chi (TC) on biobehavioral factors associated with cardiovascular disease (CVD) risk in women. DESIGN A randomized trial used a wait-list control group, pretest-posttest design. Data were collected immediately before, immediately after, and 2 months following the intervention. SETTING The study was community based in central Virginia. SUBJECTS Women aged 35 to 50 years at increased risk for CVD. INTERVENTION The 8-week intervention built on prior work and was designed to impact biobehavioral factors associated with CVD risk in women. MEASURES Biological measures included fasting glucose, insulin, and lipids as well as C-reactive protein and cytokines. Behavioral measures included fatigue, perceived stress, depressive symptoms, social support, mindfulness, self-compassion, and spiritual thoughts and behaviors. ANALYSIS A mixed effects linear model was used to test for differences between groups across time. RESULTS In 63 women, TC was shown to decrease fatigue (∂ [difference in group means] = 9.38, p = .001) and granulocyte colony stimulating factor (∂ = 12.61, p = .052). Consistent with the study model and intervention design, significant changes observed 2 months post intervention indicated that TC may help down-regulate proinflammatory cytokines associated with underlying CVD risk, including interferon gamma (∂ = 149.90, p = .002), tumor necrosis factor (∂ = 16.78, p = .002), interleukin (IL) 8 (∂ = 6.47, p = .026), and IL-4 (∂ = 2.13, p = .001), and may increase mindfulness (∂ = .54, p = .021), spiritual thoughts and behaviors (∂ = 8.30, p = .009), and self-compassion (∂ = .44, p = .045). CONCLUSION This study contributes important insights into the potential benefits and mechanisms of TC and, with further research, may ultimately lead to effective strategies for reducing CVD risk in women earlier in the CVD trajectory.
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Affiliation(s)
| | - R K Elswick
- Virginia Commonwealth University, Richmond, Virginia
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18
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Mehta PK, Wei J, Wenger NK. Ischemic heart disease in women: a focus on risk factors. Trends Cardiovasc Med 2015; 25:140-51. [PMID: 25453985 PMCID: PMC4336825 DOI: 10.1016/j.tcm.2014.10.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/08/2014] [Accepted: 10/09/2014] [Indexed: 02/08/2023]
Abstract
Heart disease remains a major contributor to morbidity and mortality in women in the United States and worldwide. This review highlights known and emerging risk factors for ischemic heart disease (IHD) in women. Traditional Framingham risk factors such as hypertension, hyperlipidemia, diabetes, smoking, as well as lifestyle habits such as unhealthy diet and sedentary lifestyle are all modifiable. Health care providers should be aware of emerging cardiac risk factors in women such as adverse pregnancy outcomes, systemic autoimmune disorders, obstructive sleep apnea, and radiation-induced heart disease; psychosocial factors such as mental stress, depression, anxiety, low socioeconomic status, and work and marital stress play an important role in IHD in women. Appropriate recognition and management of an array of risk factors is imperative given the growing burden of IHD and need to deliver cost-effective, quality care for women.
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Affiliation(s)
- Puja K Mehta
- Barbra Streisand Women׳s Heart Center, Cedars-Sinai Heart Institute, 127S San Vicente Boulevard, A 3212, Los Angeles, CA 90048.
| | - Janet Wei
- Barbra Streisand Women׳s Heart Center, Cedars-Sinai Heart Institute, 127S San Vicente Boulevard, A 3212, Los Angeles, CA 90048
| | - Nanette K Wenger
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
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19
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Wenger NK. Transforming Cardiovascular Disease Prevention in Women: Time for the Pygmalion Construct to End. Cardiology 2014; 130:62-8. [DOI: 10.1159/000370018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/20/2014] [Indexed: 11/19/2022]
Abstract
The transformation of cardiovascular disease prevention for women must address that a number of nontraditional atherosclerotic cardiovascular disease risk factors are unique to or predominant in women. As well, many traditional atherosclerotic cardiovascular disease risk factors impart differential risks for women and for men. Gender-specific risk assessment and management have the potential to improve atherosclerotic cardiovascular disease outcomes in women.
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20
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Breunig IM, Shaya FT, Tevie J, Roffman D. Incident depression increases medical utilization in Medicaid patients with hypertension. Expert Rev Cardiovasc Ther 2014; 13:111-8. [PMID: 25487173 DOI: 10.1586/14779072.2014.969712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED Hypertension is an important risk factor for cardiovascular disease and occurs disproportionately among patients with depression. Few studies have rigorously examined outcomes specifically among hypertensive patients with newly diagnosed comorbid depression. AIM We hypothesized that incident depression would exacerbate hypertensive disease and that this would be evident through greater utilization of medical services than would otherwise occur in the absence of depression. METHODS Claims data for hypertensive patients enrolled in Maryland Medicaid (2005-2010) were used to estimate the change in annualized utilization following incident depression, compared to a matched cohort of hypertensive patients never diagnosed with depression. Multivariate regression was used to adjust for changes in antihypertensive medications, adherence and comorbidity that followed depression onset. RESULTS While medical utilization increased after incident depression, additional encounters tended to be for nonacute medical care and there was no significant increase in encounters specifically for cardiovascular or hypertension-related conditions. DISCUSSION The results contribute to the discussion on the relationship between depression and cardiovascular disease and will inform future studies that aim to look at longer term outcomes in patients with hypertension.
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Affiliation(s)
- Ian Michael Breunig
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch St, 12th Floor, Baltimore, MD 21201, USA
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21
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Abstract
Diseases once associated with older adulthood, type 2 diabetes and cardiovascular disease, are increasingly diagnosed in children and adolescents. Interventions designed to assist adults in modifying dietary and physical activity habits have been shown to help prevent the development of type 2 diabetes and cardiovascular disease in adults. Given the unfortunate rise in both of these diseases in pediatric populations, it is increasingly important to begin prevention efforts in childhood or prenatally. There is strong empirical support for utilizing lifestyle interventions to prevent these diseases in adults; it is not clear whether the same holds true for pediatric populations. The present review examines lifestyle management efforts to prevent type 2 diabetes and cardiovascular disease in children across socioecological levels. Recommendations are made for expanding the traditional focus of lifestyle interventions from dietary and physical activity behaviors to target additional risks for these diseases such as smoking and depression in youth.
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Affiliation(s)
- Dorothy J. Van Buren
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 South Euclid, St. Louis, MO 63110 USA
| | - Tiffany L. Tibbs
- School of Advanced Studies and College of Social Sciences, University of Phoenix, 3157 E. Elwood St., Phoenix, AZ 85034 USA
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22
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Wassertheil-Smoller S, Arredondo EM, Cai J, Castaneda SF, Choca JP, Gallo LC, Jung M, LaVange LM, Lee-Rey ET, Mosley T, Penedo FJ, Santistaban DA, Zee PC. Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol 2014; 24:822-30. [PMID: 25439033 DOI: 10.1016/j.annepidem.2014.09.003] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe prevalence and relationships to cardiovascular morbidity of depression, anxiety, and medication use among Hispanic/Latinos of different ethnic backgrounds. METHODS Cross-sectional analysis of 15,864 men and women aged 18 to 74 years in the population-based Hispanic Community Health Study/Study of Latinos. Depressive and anxiety symptoms were assessed with shortened Center for Epidemiological Studies Depression Scale and Spielberger Trait Anxiety Scale. RESULTS Prevalence of high depressive symptoms ranged from low of 22.3% (95% confidence interval [CI], 20.4-24.3) to high of 38.0% (95% CI, 35.2-41.0) among those of Mexican or Puerto Rican background, respectively. Adjusted odds ratios for depression rose monotonically with number of cardiovascular disease (CVD) risk factor from 1.46 (95% CI, 1.18-1.75) for those with one risk factors to 4.36 (95% CI, 2.47-7.70) for those with five risk factors. Antidepressant medication was used by 5% with striking differences between those with and without history of CVD (15.4% and 4.6%, respectively) and between insured (8.2%) and uninsured (1.8%). CONCLUSIONS Among US Hispanics/Latinos, high depression and anxiety symptoms varied nearly twofold by Hispanic background and sex, history of CVD, and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population, suggesting under treatment especially among those who had no health insurance.
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Affiliation(s)
| | - Elva M Arredondo
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - JianWen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sheila F Castaneda
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - James P Choca
- Department of Psychology, San Diego State University, San Diego, CA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Molly Jung
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Lisa M LaVange
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Elizabeth T Lee-Rey
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Thomas Mosley
- Department of Medicine (Geriatrics), University of Mississippi Medical Center, Jackson
| | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | | | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Handberg EM, Eastwood JA, Eteiba W, Johnson BD, Krantz DS, Thompson DV, Vaccarino V, Bittner V, Sopko G, Pepine CJ, Merz NB, Rutledge TR. Clinical implications of the Women's Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes. ACTA ACUST UNITED AC 2014; 9:479-90. [PMID: 24007253 DOI: 10.2217/whe.13.50] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Cardiovascular disease remains the leading cause of death in the USA and is associated with several modifiable (hypertension, diabetes, high cholesterol, tobacco use, physical inactivity, obesity and unhealthy diet) and nonmodifiable (age, gender and family history) risk factors. The role of psychosocial risk factors in the development of cardiovascular disease has a growing body of literature, and differences in men and women have been identified. The Women's Ischemia Syndrome Evaluation provides insight into psychosocial risk factors in a cohort of women presenting with chest pain who had a comprehensive battery of psychosocial assessments and long-term follow-up. This review focuses on symptom presentation for chest pain and its relationship to cardiovascular disease morbidity and mortality, quality of life, healthcare costs and psychosocial predictor variables, including anxiety, depression, hostility and social networks. In the Women's Ischemia Syndrome Evaluation, persistent chest pain was associated with an increased rate of adverse events and relatively high rates of depression and anxiety, with reduced functional capacity and impaired quality of life, over a median of 6 years of follow-up. More research is needed to better understand the relationships between symptoms and negative emotions and to determine whether psychological (pharmacologic and/or cognitive) interventions might impact both psychological and cardiovascular outcomes.
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Affiliation(s)
- Eileen M Handberg
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.
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24
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Biopsychosocial Determinants of Health and Quality of life Among Young Women with Coronary Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0366-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Approximately one out of every five patients with cardiovascular disease (CVD) suffers from major depressive disorder (MDD). Both MDD and depressive symptoms are risk factors for CVD incidence, severity and outcomes. Great progress has been made in understanding potential mediators between MDD and CVD, particularly focusing on health behaviors. Investigators have also made considerable strides in the diagnosis and treatment of depression among patients with CVD. At the same time, many research questions remain. In what settings is depression screening most effective for patients with CVD? What is the optimal screening frequency? Which therapies are safe and effective? How can we better integrate the care of mental health conditions with that of CVD? How do we motivate depressed patients to change health behaviors? What technological tools can we use to improve care for depression? Gaining a more thorough understanding of the links between MDD and heart disease, and how best to diagnose and treat depression among these patients, has the potential to substantially reduce morbidity and mortality from CVD.
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Depression increases stroke hospitalization cost: an analysis of 17,010 stroke patients in 2008 by race and gender. Stroke Res Treat 2013; 2013:846732. [PMID: 23555070 PMCID: PMC3608101 DOI: 10.1155/2013/846732] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 01/31/2013] [Indexed: 12/21/2022] Open
Abstract
Objective. This analysis focuses on the effect of depression on the cost of hospitalization of stroke patients. Methods. Data on 17,010 stroke patients (primary diagnosis) were extracted from 2008 Tennessee Hospital Discharge Data System. Three groups of patients were compared: (1) stroke only (SO, n = 7,850), (2) stroke + depression (S+D, n = 3,965), and (3) stroke + other mental health diagnoses (S+M, n = 5,195). Results. Of all adult patients, 4.3% were diagnosed with stroke. Stroke was more prevalent among blacks than whites (4.5% versus 4.2%, P < 0.001) and among males than females (5.1% versus 3.7%, P < 0.001). Nearly one-quarter of stroke patients (23.3%) were diagnosed with depression/anxiety. Hospital stroke cost was higher among depressed stroke patients (S+D) compared to stroke only (SO) patients ($77,864 versus $47,790, P < 0.001), and among S+D, cost was higher for black males compared to white depressed males ($97,196 versus $88,115, P < 0.001). Similar racial trends in cost emerged among S+D females. Conclusion. Depression in stroke patients is associated with increased hospitalization costs. Higher stroke cost among blacks may reflect the impact of comorbidities and the delay in care of serious health conditions. Attention to early detection of depression in stroke patients might reduce inpatient healthcare costs.
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Cserép Z, Losoncz E, Balog P, Szili-Török T, Husz A, Juhász B, Kertai MD, Gál J, Székely A. The impact of preoperative anxiety and education level on long-term mortality after cardiac surgery. J Cardiothorac Surg 2012; 7:86. [PMID: 22973828 PMCID: PMC3485128 DOI: 10.1186/1749-8090-7-86] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 09/07/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychosocial factors have shown independent predictive value in the development of cardiovascular diseases. Although there is strong evidence to support the role of psychosocial factors in cardiovascular mortality, there is a scarcity of knowledge about how these factors are related. Therefore, we investigated the relationship between depression, anxiety, education, social isolation and mortality 7.5 years after cardiac surgery. METHODS After informed consent, 180 patients undergoing cardiac surgery between July 2000 and May 2001 were prospectively enrolled and followed for ten years. During the follow-up period, the patients were contacted annually by mail. Anxiety (Spielberger State-Trait Anxiety Inventory, STAI-S/STAI-T), depression (Beck Depression Inventory, BDI) and the number and reason for rehospitalizations were assessed each year. Those patients who did not respond were contacted by telephone, and national registries were searched for deaths. RESULTS During a median follow-up of 7.6 years (25th to 75th percentile, 7.4 to 8.1 years), the mortality rate was 23.6% (95% confidence interval [CI] 17.3-29.9; 42 deaths). In a Cox regression model, the risk factors associated with an increased risk of mortality were a higher EUROSCORE (points; Adjusted Hazard Ratio (AHR):1.30, 95%CI:1.07-1.58)), a higher preoperative STAI-T score (points; AHR:1.06, 95%CI 1.02-1.09), lower education level (school years; AHR:0.86, 95%CI:0.74-0.98), and the occurrence of major adverse cardiac and cerebral events during follow up (AHR:7.24, 95%CI:2.65-19.7). In the postdischarge model, the same risk factors remained. CONCLUSIONS Our results suggest that the assessment of psychosocial factors, particularly anxiety and education may help identify patients at an increased risk for long-term mortality after cardiac surgery.
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Affiliation(s)
- Zsuzsanna Cserép
- Department of Anesthesiology and Intensive Care, Semmelweis University, Budapest, Hungary
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Lutwak N, Dill C. Depression and cardiovascular disease in women. J Womens Health (Larchmt) 2012; 21:702; author reply 703. [PMID: 22519632 DOI: 10.1089/jwh.2012.3626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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