Chen Qian, Zhao Wanying, Zhang Qi, Li Siqi, Zhao Jiaqi, Chen Wanlan, Xia Min, Liu Yan
Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangdong, China.
Can J Cardiol. 2024 Dec;40(12):2640-2648. doi: 10.1016/j.cjca.2024.08.280. Epub 2024 Aug 30.
Depression is an increasing illness worldwide that severely diminishes the quality of life. In this study we sought to elucidate the association of the American Heart Association's Life's Essential 8 (LE8) metrics with the incidence of cardiovascular disease (CVD) among depression participants and further quantify the related theoretical reduction of long-term CVD burden.
We included 20,832 participants with depression from the UK Biobank. LE8, including diet quality, physical activity, nicotine exposure, sleep duration, body mass index, lipids, glucose, and blood pressure, was calculated at baseline and categorized into low, medium, and high levels. Hazard ratios (HRs) and 95% confidence interval (CI) for major cardiovascular events (MACE) were calculated using Cox models. We further quantified the population-attributable fraction (PAF) for CVD.
During a median follow-up of 12.0 years, 658 MACE were recorded. After multi-variable adjustment, compared with participants with low LE8, people with high LE8 had a decreased risk of MACE (HR, 0.32; 95% CI, 0.22-0.47), non-fatal MACE (HR, 0.39, 0.26-0.61), myocardial infarction (HR, 0.23, 0.12-0.44), and ischemic stroke (HR, 0.52, 0.27-0.99). Overall 50.7% (95% CI, 34.5%-66.9%) of MACE and 48.0% (95% CI, 29.5%-66.4%) of nonfatal MACE were attributable to the low and medium adherence to LE8 at the 5-year follow-up, respectively. Suboptimal control of blood pressure ranked as the top contributor to all types of CVD in individuals with depression.
Optimal adherence to LE8 was associated with lower burden of CVD in those with depression. Adopting a comprehensive lifestyle intervention might help further reduce CVD burden in those with mental disorders.
抑郁症在全球范围内呈上升趋势，严重降低生活质量。在本研究中，我们试图阐明美国心脏协会的生命基本八项（LE8）指标与抑郁症患者心血管疾病（CVD）发病率之间的关联，并进一步量化长期CVD负担的相关理论降低情况。
我们纳入了英国生物银行的20832名抑郁症患者。LE8包括饮食质量、身体活动、尼古丁暴露、睡眠时间、体重指数、血脂、血糖和血压，在基线时进行计算，并分为低、中、高三个水平。使用Cox模型计算主要心血管事件（MACE）的风险比（HR）和95%置信区间（CI）。我们进一步量化了CVD的人群归因分数（PAF）。
在中位随访12.0年期间，记录了658例MACE。多变量调整后，与LE8低的参与者相比，LE8高的参与者发生MACE的风险降低（HR，0.32；95%CI，0.22 - 0.47），非致命性MACE（HR，0.39，0.26 - 0.61），心肌梗死（HR，0.23，0.12 - 0.44）和缺血性中风（HR，0.52，0.27 - 0.99）。在5年随访时，总体上50.7%（95%CI，34.5% - 66.9%）的MACE和48.0%（95%CI，29.5% - 66.4%）的非致命性MACE分别归因于对LE8的低和中等依从性。血压控制不佳是抑郁症患者各类CVD的首要促成因素。
对LE8的最佳依从性与抑郁症患者较低的CVD负担相关。采取全面的生活方式干预可能有助于进一步降低精神障碍患者的CVD负担。
