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Depressive symptoms are related to progression of coronary calcium in midlife women: The Study of Women's Health Across the Nation (SWAN) Heart Study - 06/08/11

Doi : 10.1016/j.ahj.2011.03.017 
Imke Janssen a, , Lynda H. Powell a, Karen A. Matthews b, John F. Cursio a, Steven M. Hollenberg c, Kim Sutton-Tyrrell d, Joyce T. Bromberger d, Susan A. Everson-Rose e
a Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 
b Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 
c Division of Cardiology, Cooper University Hospital, Camden, NJ 
d Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 
e Department of Medicine, University of Minnesota, Minneapolis, MN 

Reprint requests: Imke Janssen, PhD, Department of Preventive Medicine, 1700 W. van Buren, Suite 470, Chicago, IL 60612.

Riassunto

Background

Major depression and depressive symptoms are associated with cardiovascular disease (CVD), but the impact of depression on early atherogenesis is less well known, particularly in women and minorities. This study examined whether depressive symptoms are associated with progression of coronary artery calcification (CAC) among women at midlife.

Methods

The SWAN is a longitudinal, multisite study assessing health and psychologic factors in midlife women. An ancillary study (SWAN Heart) evaluated subclinical atherosclerosis in women who reported no history of CVD or diabetes. In 346 women, CAC was measured twice by electron beam computed tomography, an average of 2.3 years apart. Progression, defined as an increase by ≥10 Agatston units, was analyzed using relative risk (RR) regression. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression (CES-D) Scale.

Results

Progression of CAC was observed in 67 women (19.1%). Each 1-SD-higher CES-D score at baseline related to a 25% increased risk of CAC progression (RR 1.25, 95% CI 1.06-1.47, P = .007), adjusting for age, time between scans, ethnicity, education, menopausal status, and known CVD risk factors. This risk was similar to the risk induced by body mass index (RR 1.31, 95% CI 1.11-1.54, P = .001) and systolic blood pressure (RR 1.28, 95% CI 1.06-1.55, P = .01).

Conclusions

Depressive symptoms were independently associated with progression of CAC in this cohort of midlife women. Depressive symptoms may represent a risk factor that is potentially modifiable for early prevention of CVD in women.

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 The SWAN study has grant support from the National Institutes of Health through the National Institute of Aging, the National Institute of Nursing Research, and the National Institutes of Health Office of Research on Women's Health (grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495).
 SWAN Heart was supported by grants from the National Heart, Lung, and Blood Institute (HL065581, HL065591, HL089862).


© 2011  Mosby, Inc. Tutti i diritti riservati.
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Vol 161 - N° 6

P. 1186 - Giugno 2011 Ritorno al numero
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