Ferketich A K, Schwartzbaum J A, Frid D J, Moeschberger M L
Division of Epidemiology and Biometrics, The Ohio State University College of Medicine and Public Health, Columbus 43210, USA.
Arch Intern Med. 2000 May 8;160(9):1261-8. doi: 10.1001/archinte.160.9.1261.
Depression predicts morbidity and mortality among individuals who have coronary heart disease (CHD), and there is increasing evidence that depression may also act as an antecedent to CHD. The studies that have reported a relationship between depression and CHD incidence or mortality either were restricted to men only or analyzed women and men together. The present investigation was conducted to evaluate the differential effect depression may have on CHD incidence and mortality in women and men.
We analyzed data from 5007 women and 2886 men enrolled in the first National Health and Nutrition Examination Survey (NHANES I) who were free of CHD at the 1982-1984 interview and who had completed the Center for Epidemiologic Studies Depression Scale (CES-D). Participants were evaluated from the 1982 interview date either until the end of the study (1992 interview date) or until the occurrence of a CHD event. Using CHD incidence and CHD mortality (International Classification of Disease, Ninth Revision, codes 410-414) as the outcome variables, Cox proportional hazards regression models were developed to evaluate the relative risk (RR) of CHD incidence and mortality in the depressed women and men separately, controlling for standard CHD risk factors.
The women experienced 187 nonfatal and 137 fatal events, compared with 187 nonfatal and 129 fatal events among the men. The adjusted RR of CHD incidence among depressed women was 1.73 (95% confidence internal [CI], 1.11-2.68) compared with nondepressed women. Depression had no effect on CHD mortality in the women (RR, 0.74; 95% CI, 0.40-1.48). The adjusted RR of CHD incidence among depressed men was 1.71 (95% CI, 1.14-2.56) compared with nondepressed men. Depressed men also had an increased risk of CHD mortality compared with their nondepressed counterparts, with an adjusted RR of 2.34 (95% CI, 1.54-3.56).
In this sample, while controlling for possible confounding factors, depression was associated with an increased risk of CHD incidence in both men and women, as well as CHD mortality in men. Depression had no effect on CHD mortality in women.
抑郁症可预测冠心病（CHD）患者的发病率和死亡率，且越来越多的证据表明抑郁症可能也是冠心病的一个先兆。已报告的抑郁症与冠心病发病率或死亡率之间关系的研究，要么仅局限于男性，要么对男性和女性进行综合分析。本研究旨在评估抑郁症对男性和女性冠心病发病率及死亡率可能产生的不同影响。
我们分析了参加首次全国健康与营养检查调查（NHANES I）的5007名女性和2886名男性的数据。这些参与者在1982 - 1984年的访谈中无冠心病，并完成了流行病学研究中心抑郁量表（CES - D）。从1982年访谈日期开始对参与者进行评估，直至研究结束（1992年访谈日期）或发生冠心病事件。以冠心病发病率和冠心病死亡率（国际疾病分类第九版，编码410 - 414）作为结局变量，建立Cox比例风险回归模型，分别评估抑郁女性和男性中冠心病发病率和死亡率的相对风险（RR），同时控制标准的冠心病危险因素。
女性发生了187例非致命事件和137例致命事件，男性发生了187例非致命事件和129例致命事件。与非抑郁女性相比，抑郁女性中冠心病发病率的校正RR为1.73（95%置信区间[CI]，1.11 - 2.68）。抑郁症对女性冠心病死亡率无影响（RR，0.74；95% CI，0.40 - 1.48）。与非抑郁男性相比，抑郁男性中冠心病发病率的校正RR为1.71（95% CI，1.14 - 2.56）。与非抑郁男性相比，抑郁男性的冠心病死亡率风险也增加，校正RR为2.34（95% CI，1.54 - 3.56）。
在本样本中，在控制可能的混杂因素的情况下，抑郁症与男性和女性冠心病发病率增加以及男性冠心病死亡率增加相关。抑郁症对女性冠心病死亡率无影响。
