Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
Department of Cardiology, Shengli Oilfield Central Hospital, Dongying, Shandong, China.
Psychiatry Res. 2023 Feb;320:115051. doi: 10.1016/j.psychres.2023.115051. Epub 2023 Jan 11.
The intervention of depression was considered a prevention and treatment option for cardiovascular disease (CVD). However, evidence regarding whether association of depression with mortality differed among people at high or low risk of CVD yielded conflicting results. We aimed to investigate associations between depression and all-cause and CVD mortality among 3854 and 3044 US adults at high and low baseline risk of CVD, respectively. Among participants at high risk of CVD, depression and per 5-point increase in PHQ-9 score were associated with 81% (HR=1.81, 95%CI: 1.15-2.86) and 33% (HR=1.33, 95%CI: 1.14-1.55) increased all-cause mortality, respectively. We did not find statistically significant associations between depression (HR=1.40, 95%CI: 0.67-2.95) and PHQ-9 score (HR=1.28, 95%CI: 1.00-1.63) with CVD mortality due to a small number of mortality events. Among people with low risk of CVD, each 5-point increment in PHQ-9 score was associated with all-cause mortality (HR=1.26, 95%CI: 1.02-1.56), while there was no statistically significant association of depression with all-cause mortality (HR=1.69, 95%CI: 0.75-3.81) and CVD mortality (HR=1.99, 95%CI: 0.83-4.81). This study found that depression was associated with all-cause mortality among individuals at a high baseline risk of CVD, but no significant association was observed in people at a low baseline risk of CVD.
抑郁的干预被认为是心血管疾病（CVD）的预防和治疗选择。然而，关于抑郁与死亡率之间的关联是否因 CVD 高危人群和低危人群而有所不同，结果存在争议。我们旨在调查分别处于 CVD 高基线风险和低基线风险的 3854 名和 3044 名美国成年人中，抑郁与全因和 CVD 死亡率之间的关系。在 CVD 高危人群中，抑郁和 PHQ-9 评分每增加 5 分，全因死亡率分别增加 81%（HR=1.81，95%CI：1.15-2.86）和 33%（HR=1.33，95%CI：1.14-1.55）。我们没有发现抑郁（HR=1.40，95%CI：0.67-2.95）和 PHQ-9 评分（HR=1.28，95%CI：1.00-1.63）与 CVD 死亡率之间存在统计学显著关联，这可能是由于死亡率事件数量较少所致。在 CVD 低危人群中，PHQ-9 评分每增加 5 分，全因死亡率就会增加（HR=1.26，95%CI：1.02-1.56），而抑郁与全因死亡率（HR=1.69，95%CI：0.75-3.81）和 CVD 死亡率（HR=1.99，95%CI：0.83-4.81）之间没有统计学显著关联。本研究发现，抑郁与 CVD 高基线风险个体的全因死亡率相关，但在 CVD 低基线风险个体中未观察到显著关联。
