TY - JOUR
T1 - Associations between depressive symptoms, cigarette smoking, and cardiovascular health
T2 - Longitudinal results from CARDIA
AU - Carroll, Allison J.
AU - Huffman, Mark D.
AU - Zhao, Lihui
AU - Jacobs, David R.
AU - Stewart, Jesse C.
AU - Kiefe, Catarina I.
AU - Brunner, Wendy
AU - Liu, Kiang
AU - Hitsman, Brian
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - Cardiovascular health
KW - Depression
KW - Health risk behaviors
KW - Prospective study
KW - Smoking
KW - Trajectory modeling
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U2 - 10.1016/j.jad.2019.09.049
DO - 10.1016/j.jad.2019.09.049
M3 - Article
C2 - 31539696
AN - SCOPUS:85072226264
SN - 0165-0327
VL - 260
SP - 583
EP - 591
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
