Zhang Z W, Hua Y M, Liu A P
Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Jun 18;55(3):465-470. doi: 10.19723/j.issn.1671-167X.2023.03.012.
To explore joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease (CVD) in middle-aged and elderly people in China.
Based on China Health and Retirement Longitudinal Study(CHARLS)database using 2011 baseline data and the follow-up cohort data of 2013, 2015 and 2018, describe the distribution characteristics of baseline depressive symptoms and 10-year risk of ischemic cardiovascular disease in 2011. Cox survival analysis model was used to analyze the individual, independent and joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with cardiovascular disease.
A total of 9 412 subjects were enrolled. The detection rate of depressive symptoms at baseline was 44.7%, and the 10-year middle and high risk of ischemic cardiovascular disease was 13.62%. During an average follow-up of 6.19 (6.19±1.66) years, 1 401 cases of cardiovascular disease were diagnosed in 58 258 person-years, revealing an overall incidence density of 24.048/1 000 person-years. After adjusting the factors, in terms of individual impact, the participants with depressive symptoms had a higher risk of developing CVD (=1.263, 95%: 1.133-1.408), while medium to high risk of ischemic cardiovascular disease had a higher risk of developing CVD (=1.892, 95%: 1.662-2.154). Among independent influences, participants with depressive symptoms had a higher risk of developing CVD (=1.269, 95% : 1.138-1.415), while medium to high risk of 10-year risk of ischemic cardiovascular disease had a higher risk of developing CVD (=1.898, 95%: 1.668-2.160). Joint impact result showed the incidence of cardiovascular disease in the low risk of 10-year risk of ischemic cardiovascular disease with depressive symptoms group, middle and high risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms group, and 10-year middle and high risk of ischemic cardiovascular disease with depressive symptoms group were 1.390, 2.149, and 2.339 times higher than that of low risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms ( < 0.001).
The superimposed depression symptoms of the middle and high-risk population at the 10-year risk of ischemic cardiovascular disease will aggravate the risk of cardiovascular disease in middle-aged and elderly people. In combination with the actual lifestyle intervention and physical index health management, attention should be paid to mental health intervention.
探讨中国中老年人群抑郁症状与缺血性心血管疾病(CVD)10年发病风险的联合关联。
基于中国健康与养老追踪调查(CHARLS)数据库,使用2011年基线数据以及2013年、2015年和2018年的随访队列数据,描述2011年基线抑郁症状分布特征及缺血性心血管疾病10年发病风险。采用Cox生存分析模型分析抑郁症状及缺血性心血管疾病10年发病风险与心血管疾病的个体、独立及联合关联。
共纳入9412名受试者。基线抑郁症状检出率为44.7%,缺血性心血管疾病10年中高危风险为13.62%。在平均随访6.19(6.19±1.66)年期间,58258人年中诊断出1401例心血管疾病,总发病密度为24.048/1000人年。调整因素后,就个体影响而言,有抑郁症状的参与者发生CVD的风险更高(=1.263,95%:1.133 - 1.408),而缺血性心血管疾病中高危风险者发生CVD的风险更高(=1.892,95%:1.662 - 2.154)。在独立影响方面,有抑郁症状的参与者发生CVD的风险更高(=1.269,95%:1.138 - 1.415),而缺血性心血管疾病10年发病风险中高危者发生CVD的风险更高(=1.898,95%:1.668 - 2.160)。联合影响结果显示,缺血性心血管疾病10年发病风险低且有抑郁症状组、缺血性心血管疾病10年发病风险中高危且无抑郁症状组、缺血性心血管疾病10年发病风险中高危且有抑郁症状组的心血管疾病发病率分别比缺血性心血管疾病10年发病风险低且无抑郁症状组高1.390倍、2.149倍和2.339倍(<0.001)。
缺血性心血管疾病10年发病风险中高危人群叠加抑郁症状会加重中老年人心血管疾病风险。结合实际生活方式干预和身体指标健康管理,应重视心理健康干预。