Depression Linked to 14% Increased Risk for Heart Failure
A history of depression was associated with a 14% higher risk for incident heart failure (HF) than no history of depression in a new study, even after adjusting for known HF risk factors and sociodemographic data.
METHODOLOGY:
This cohort study analyzed data of more than 2.8 million US veterans (median age, 54 years; 94% men; 69.5% White individuals; and 20% Black individuals) of the Veterans Affairs Birth Cohort between 2000 and 2015, with a median follow-up of 6.9 years.
The included participants were free of HF at baseline and had three outpatient visits within 5 years.
The time to incident HF was compared among participants with prevalent depression at baseline (8%) and those without depression at and after baseline.
The analysis was adjusted for sociodemographic covariates, such as age, sex, race, and ethnicity, and clinical comorbidities and HF risk factors, such as diabetes, cholesterol, coronary artery disease, stroke, and atrial fibrillation.
TAKEAWAY:
Participants with depression had a higher rate of incident HF than those without depression (136.9 vs 114.6 cases per 10,000 person-years).
After adjusting for covariates and cardiovascular risk factors, participants with depression had a 14% increased risk for incident HF compared with those without depression (adjusted hazard ratio [HR], 1.14; 95% CI, 1.13-1.16).
Analysis of a low-risk cohort without comorbidities at baseline revealed that depression was associated with a 58% higher risk for incident HF (adjusted HR, 1.58; 95% CI, 1.39-1.80) after adjustment.
Among participants with prevalent depression, men had a greater risk for incident HF than women (adjusted HR, 1.70; 95% CI, 1.60-1.80).
IN PRACTICE:
'Depression is a leading cause of disability around the world, affecting 4.4% of the world's population (322 million people), and this rate continues to increase. Thus, depression remains a widely prevalent disease and a risk factor for HF that may be modifiable,' the investigators wrote.
SOURCE:
The study was led by Jamie L. Pfaff, MD, Vanderbilt University Medical Center in Nashville, Tennessee. It was published online on May 8 in JAMA Network Open .
LIMITATIONS:
This retrospective study relied on older electronic health record data and billing codes through 2015, which may have led to misclassification bias. It lacked detailed information on depression treatment and socioeconomic risk factors, and it did not compare depression with other mental health conditions linked to cardiovascular risk.
DISCLOSURES:
The study was funded by the National Institutes of Health. One investigator reported receiving grants from the National Institutes of Health during the conduct of the study.
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