Loomba Rohit S, Aggarwal Saurabh, Arora Rohit
1Children's Hospital of Wisconsin, Medical College of Wisconsin Affiliated Hospitals, Wauwatosa, WI; and 2Chicago Medical School, North Chicago, IL.
Am J Ther. 2015 Sep-Oct;22(5):382-7. doi: 10.1097/MJT.0000000000000043.
Although depression has been reported to be associated with various cardiovascular risk factors, whether an association exists between depression and prevalence of cardiovascular events is not well known. In particular, the effect of symptom frequency and cardiovascular events has not been described. Data were collected for patients older than 45 years from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) data to study whether an association exists between depression and prevalence of coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), and stroke. The NHANES database is a nationally representative probability sample of noninstitutionalized US civilians. We divided patients feeling down/depressed/hopeless into 1 of the 2 categories: symptoms less than half the days of the week and those with less frequent symptoms. Logistic regression analysis was used to adjust for other covariates. A P value of <0.05 was considered statistically significant. More than 2700 patients were studied to analyze the association between severity of depression and prevalence of CAD, MI, CHF, and stroke. Significant associations were noted between depressive symptoms and prevalence of CAD, MI, CHF, and stroke. Those who reported being depressed more than half of the days of the week had 1.95 times greater odds of CAD [95% confidence interval (CI), 1.2473-3.0523], 2.54 times greater odds of CHF (95% CI, 1.6114-4.0126), 2.65 times greater odds of MI (95% CI, 1.7789-3.9521), and 1.91 greater odds of stroke (95% CI, 1.2002-3.0356) when compared with those who reported being depressed less than half of the days of the week. The results of this study suggest that the prevalence of CAD, MI, CHF, and stroke are significantly increased in individuals who report feeling down/depressed/hopeless for more than half the days of the week.
尽管据报道抑郁症与多种心血管危险因素相关，但抑郁症与心血管事件患病率之间是否存在关联尚不清楚。特别是，症状频率与心血管事件之间的关系尚未得到描述。我们收集了2007 - 2008年美国国家健康与营养检查调查（NHANES）中45岁以上患者的数据，以研究抑郁症与冠状动脉疾病（CAD）、心肌梗死（MI）、充血性心力衰竭（CHF）和中风患病率之间是否存在关联。NHANES数据库是美国非机构化平民具有全国代表性的概率样本。我们将感到情绪低落/抑郁/绝望的患者分为两类：一周中症状出现天数少于一半的患者和症状出现频率较低的患者。采用逻辑回归分析来调整其他协变量。P值<0.05被认为具有统计学意义。对2700多名患者进行了研究，以分析抑郁症严重程度与CAD、MI、CHF和中风患病率之间的关联。抑郁症状与CAD、MI、CHF和中风患病率之间存在显著关联。与那些报告一周中情绪低落/抑郁/绝望天数少于一半的人相比，那些报告一周中超过一半天数情绪低落/抑郁/绝望的人患CAD的几率高1.95倍[95%置信区间（CI），1.2473 - 3.0523]，患CHF的几率高2.54倍（95% CI，1.6114 - 4.0126），患MI的几率高2.65倍（95% CI，1.7789 - 3.9521），患中风的几率高1.91倍（95% CI，1.2002 - 3.0356）。这项研究的结果表明，一周中超过一半天数感到情绪低落/抑郁/绝望的个体中，CAD、MI、CHF和中风的患病率显著增加。
