Skip to main content
Top
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Affective Disorder | Research article

10-year ASCVD risk is positively correlated with depressive symptoms in a large general population

Authors: Guo-Zhe Sun, Ning Ye, Shao-Jun Wu, Ying Zhou, Ying-Xian Sun

Published in: BMC Psychiatry | Issue 1/2019

Login to get access

Abstract

Background

To explore the potential correlation between 10-year atherosclerotic cardiovascular disease (ASCVD) risk and depressive symptoms in a general population.

Methods

A cross-sectional study involving 11,956 permanent residents of Liaoning Province in China ≥35 years of age was conducted. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) while 10-year ASCVD risk was calculated using the tool suitable for China.

Results

Males had significantly higher 10-year ASCVD risk than females (14.2 ± 10.7% vs. 9.3 ± 9.1%; P <  0.001) but lower PHQ-9 score (2.34 ± 3.13 vs. 3.63 ± 4.02; P <  0.001). The mean PHQ-9 score increased significantly with advancing 10-year ASCVD risk category in both males (from 2.03 to 2.61; P for trend < 0.001) and females (from 3.04 to 4.61; P for trend < 0.001), and the increasing trend was more apparent in females (P <  0.001). Pearson correlation analyses showed that 10-year ASCVD risk positively correlated with PHQ-9 score in both sexes (Ps <  0.001). In multivariate linear regression analyses adjusting for confounding risk factors, the independent associations of 10-year ASCVD risk with PHQ-9 score were all significant in the total (β = 2.61; P <  0.001), male (β = 1.64; P = 0.001), and female subjects (β = 3.71; P <  0.001). Further, the interaction analysis proved the impacts of 10-year ASCVD risk on PHQ-9 score were more apparent in females than males (Ps < 0.001).

Conclusions

The 10-year ASCVD risk was positively associated with depressive symptoms in both males and females, which was more apparent in the latter. These findings provided some novel data about the value of 10-year ASCVD risk in estimating depressive symptoms.
Literature
1.
go back to reference GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–71.CrossRef GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–71.CrossRef
2.
go back to reference Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S, et al. Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet. 2016;387:251–72.CrossRefPubMed Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S, et al. Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet. 2016;387:251–72.CrossRefPubMed
3.
go back to reference Wannamethee SG, Shaper AG, Lennon L, Morris RW. Metabolic syndrome vs Framingham risk score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med. 2005;165:2644–50.CrossRefPubMed Wannamethee SG, Shaper AG, Lennon L, Morris RW. Metabolic syndrome vs Framingham risk score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med. 2005;165:2644–50.CrossRefPubMed
4.
go back to reference Sara JD, Lennon RJ, Gulati R, Singh M, Holmes DR Jr, Lerman LO, et al. Utility of the Framingham risk score in predicting secondary events in patients following percutaneous coronary intervention: a time-trend analysis. Am Heart J. 2016;172:115–28.CrossRefPubMed Sara JD, Lennon RJ, Gulati R, Singh M, Holmes DR Jr, Lerman LO, et al. Utility of the Framingham risk score in predicting secondary events in patients following percutaneous coronary intervention: a time-trend analysis. Am Heart J. 2016;172:115–28.CrossRefPubMed
5.
go back to reference Yang X, Li J, Hu D, Chen J, Li Y, Huang J, et al. Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population: the China-PAR project (prediction for ASCVD risk in China). Circulation. 2016;134:1430–40.CrossRefPubMed Yang X, Li J, Hu D, Chen J, Li Y, Huang J, et al. Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population: the China-PAR project (prediction for ASCVD risk in China). Circulation. 2016;134:1430–40.CrossRefPubMed
6.
go back to reference Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Prevalence of mental disorders in Europe: results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;420:21–7. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Prevalence of mental disorders in Europe: results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;420:21–7.
7.
go back to reference Zhou X, Bi B, Zheng L, Li Z, Yang H, Song H, et al. The prevalence and risk factors for depression symptoms in a rural Chinese sample population. PLoS One. 2014;9:e99692.CrossRefPubMedPubMedCentral Zhou X, Bi B, Zheng L, Li Z, Yang H, Song H, et al. The prevalence and risk factors for depression symptoms in a rural Chinese sample population. PLoS One. 2014;9:e99692.CrossRefPubMedPubMedCentral
8.
go back to reference Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: global burden of disease study. Lancet. 1997;349:1498–504.CrossRefPubMed Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: global burden of disease study. Lancet. 1997;349:1498–504.CrossRefPubMed
9.
11.
go back to reference O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, et al. Depression is a risk factor for incident coronary heart disease in women: an 18-year longitudinal study. J Affect Disord. 2016;196:117–24.CrossRefPubMed O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, et al. Depression is a risk factor for incident coronary heart disease in women: an 18-year longitudinal study. J Affect Disord. 2016;196:117–24.CrossRefPubMed
12.
go back to reference Chen S, Fang Y, Chiu H, Fan H, Jin T, Conwell Y. Validation of the nine-item patient health questionnaire to screen for major depression in a Chinese primary care population. Asia-Pac Psychiatry. 2013;5:61–8.CrossRefPubMed Chen S, Fang Y, Chiu H, Fan H, Jin T, Conwell Y. Validation of the nine-item patient health questionnaire to screen for major depression in a Chinese primary care population. Asia-Pac Psychiatry. 2013;5:61–8.CrossRefPubMed
13.
go back to reference Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013:695925.CrossRefPubMedPubMedCentral Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013:695925.CrossRefPubMedPubMedCentral
14.
go back to reference Sun GZ, Ye N, Zhang NJ, Li Y, Chen S, Chang Y, et al. Association between CHADS2 score, depressive symptoms, and quality of life in a general population. BMC Psychiatry. 2017;17:80.CrossRefPubMedPubMedCentral Sun GZ, Ye N, Zhang NJ, Li Y, Chen S, Chang Y, et al. Association between CHADS2 score, depressive symptoms, and quality of life in a general population. BMC Psychiatry. 2017;17:80.CrossRefPubMedPubMedCentral
15.
go back to reference Sun GZ, Guo L, Wang J, Ye N, Wang XZ, Sun YX. Association between hyperuricemia and atrial fibrillation in rural China: a cross-sectional study. BMC Cardiovasc Disord. 2015;15:98.CrossRefPubMedPubMedCentral Sun GZ, Guo L, Wang J, Ye N, Wang XZ, Sun YX. Association between hyperuricemia and atrial fibrillation in rural China: a cross-sectional study. BMC Cardiovasc Disord. 2015;15:98.CrossRefPubMedPubMedCentral
16.
go back to reference Lowe B, Kroenke K, Herzog W, Grafe K. Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9). J Affect Disord. 2004;81:61–6.CrossRefPubMed Lowe B, Kroenke K, Herzog W, Grafe K. Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9). J Affect Disord. 2004;81:61–6.CrossRefPubMed
18.
go back to reference Liu N, Pan XF, Yu C, Lv J, Guo Y, Bian Z, et al. Association of Major Depression with Risk of ischemic heart disease in a mega-cohort of Chinese adults: the China Kadoorie biobank study. J Am Heart Assoc. 2016;5:e004687.PubMedPubMedCentral Liu N, Pan XF, Yu C, Lv J, Guo Y, Bian Z, et al. Association of Major Depression with Risk of ischemic heart disease in a mega-cohort of Chinese adults: the China Kadoorie biobank study. J Am Heart Assoc. 2016;5:e004687.PubMedPubMedCentral
19.
go back to reference Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the patient health questionnaire (PHQ-9): a meta-analysis. Can Med Assoc J. 2012;184:E191–6.CrossRef Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the patient health questionnaire (PHQ-9): a meta-analysis. Can Med Assoc J. 2012;184:E191–6.CrossRef
20.
go back to reference Zhou BF. Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002;15:245–52.PubMed Zhou BF. Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002;15:245–52.PubMed
21.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed
22.
go back to reference World Health Organization and International Diabetes Fedaration. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation. Geneva: WHO; 2006. p. 1–3. World Health Organization and International Diabetes Fedaration. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation. Geneva: WHO; 2006. p. 1–3.
23.
go back to reference Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.CrossRef Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.CrossRef
24.
go back to reference Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, et al. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med. 2004;66:305–15.PubMed Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, et al. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med. 2004;66:305–15.PubMed
25.
go back to reference Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med. 2004;66:802–13.CrossRefPubMed Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med. 2004;66:802–13.CrossRefPubMed
26.
go back to reference Nielsen TJ, Vestergaard M, Christensen B, Christensen KS, Larsen KK. Mental health status and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based cohort study. BMJ Open. 2013;3:e003045.CrossRefPubMedPubMedCentral Nielsen TJ, Vestergaard M, Christensen B, Christensen KS, Larsen KK. Mental health status and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based cohort study. BMJ Open. 2013;3:e003045.CrossRefPubMedPubMedCentral
27.
go back to reference Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med. 2006;21:30–8.CrossRefPubMedPubMedCentral Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med. 2006;21:30–8.CrossRefPubMedPubMedCentral
28.
go back to reference Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48:1527–37.CrossRefPubMed Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48:1527–37.CrossRefPubMed
29.
go back to reference Li Z, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension: a systematic review and meta-analysis. Med. 2015;94:e1317.CrossRef Li Z, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension: a systematic review and meta-analysis. Med. 2015;94:e1317.CrossRef
30.
go back to reference Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24:1069–78.CrossRefPubMed Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24:1069–78.CrossRefPubMed
31.
go back to reference Fei K, Benn EK, Negron R, Arniella G, Tuhrim S, Horowitz CR. Prevalence of depression among stroke survivors: racial-ethnic differences. Stroke. 2016;47:512–5.CrossRefPubMed Fei K, Benn EK, Negron R, Arniella G, Tuhrim S, Horowitz CR. Prevalence of depression among stroke survivors: racial-ethnic differences. Stroke. 2016;47:512–5.CrossRefPubMed
32.
go back to reference Risal A, Manandhar K, Linde M, Steiner TJ, Holen A. Anxiety and depression in Nepal: prevalence, comorbidity and associations. BMC Psychiatry. 2016;16:102.CrossRefPubMedPubMedCentral Risal A, Manandhar K, Linde M, Steiner TJ, Holen A. Anxiety and depression in Nepal: prevalence, comorbidity and associations. BMC Psychiatry. 2016;16:102.CrossRefPubMedPubMedCentral
33.
34.
go back to reference Lehto SM, Hintikka J, Niskanen L, Tolmunen T, Koivumaa-Honkanen H, Honkalampi K, et al. Low HDL cholesterol associates with major depression in a sample with a 7-year history of depressive symptoms. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:1557–61.CrossRef Lehto SM, Hintikka J, Niskanen L, Tolmunen T, Koivumaa-Honkanen H, Honkalampi K, et al. Low HDL cholesterol associates with major depression in a sample with a 7-year history of depressive symptoms. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:1557–61.CrossRef
35.
go back to reference Shin JY, Suls J, Martin R. Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Annals Behav Med. 2008;36:33–43.CrossRef Shin JY, Suls J, Martin R. Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Annals Behav Med. 2008;36:33–43.CrossRef
36.
go back to reference Kim D, Kubzansky LD, Baccarelli A, Sparrow D, Spiro A 3rd, Tarantini L, et al. Psychological factors and DNA methylation of genes related to immune/inflammatory system markers: the VA normative aging study. BMJ Open. 2016;6:e009790.CrossRefPubMedPubMedCentral Kim D, Kubzansky LD, Baccarelli A, Sparrow D, Spiro A 3rd, Tarantini L, et al. Psychological factors and DNA methylation of genes related to immune/inflammatory system markers: the VA normative aging study. BMJ Open. 2016;6:e009790.CrossRefPubMedPubMedCentral
37.
go back to reference Elderon L, Whooley MA. Depression and cardiovascular disease. Prog Cardiovasc Dis. 2013;55:511–23.CrossRefPubMed Elderon L, Whooley MA. Depression and cardiovascular disease. Prog Cardiovasc Dis. 2013;55:511–23.CrossRefPubMed
Metadata
Title
10-year ASCVD risk is positively correlated with depressive symptoms in a large general population
Authors
Guo-Zhe Sun
Ning Ye
Shao-Jun Wu
Ying Zhou
Ying-Xian Sun
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2114-7

Other articles of this Issue 1/2019

BMC Psychiatry 1/2019 Go to the issue